Provider Demographics
NPI:1104411842
Name:PLANTATION DEVELOPMENTAL PARTNERS LLC
Entity type:Organization
Organization Name:PLANTATION DEVELOPMENTAL PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-C
Authorized Official - Phone:478-272-4797
Mailing Address - Street 1:112 ROWE ST STE D
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-5266
Mailing Address - Country:US
Mailing Address - Phone:478-272-4797
Mailing Address - Fax:478-272-2271
Practice Address - Street 1:112 ROWE ST STE D
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-5266
Practice Address - Country:US
Practice Address - Phone:478-272-4797
Practice Address - Fax:478-272-2271
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLANTATION DEVELOPMENTAL PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies