Provider Demographics
NPI: | 1508036161 |
---|---|
Name: | AUGUST HEALTHCARE GROUP, LLC |
Entity type: | Organization |
Organization Name: | AUGUST HEALTHCARE GROUP, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | JOSEPH |
Authorized Official - Middle Name: | C |
Authorized Official - Last Name: | SANTOS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MPH |
Authorized Official - Phone: | 670-483-7667 |
Mailing Address - Street 1: | PO BOX 500173 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAIPAN |
Mailing Address - State: | MP |
Mailing Address - Zip Code: | 96950-0173 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 670-233-4582 |
Mailing Address - Fax: | 670-233-4584 |
Practice Address - Street 1: | 1 FIESTA BLDG |
Practice Address - Street 2: | BEACH ROAD GARAPAN |
Practice Address - City: | SAIPAN |
Practice Address - State: | MP |
Practice Address - Zip Code: | 96950 |
Practice Address - Country: | US |
Practice Address - Phone: | 670-233-4582 |
Practice Address - Fax: | 670-233-4584 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-03-10 |
Last Update Date: | 2011-09-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3416L0300X | Transportation Services | Ambulance | Land Transport |
No | 343800000X | Transportation Services | Secured Medical Transport (VAN) |