Provider Demographics
NPI:1548281462
Name:CAROLE ROMIG
Entity type:Organization
Organization Name:CAROLE ROMIG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMIG
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:912-920-0065
Mailing Address - Street 1:7074 HODGSON MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2529
Mailing Address - Country:US
Mailing Address - Phone:912-920-0065
Mailing Address - Fax:912-920-2786
Practice Address - Street 1:7074 HODGSON MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2529
Practice Address - Country:US
Practice Address - Phone:912-920-0065
Practice Address - Fax:912-920-2786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA8202211OtherUHC MEDICARE COMPLETE HMO
SCDE3239Medicaid
SCDE3239Medicaid
GA8202211OtherUHC MEDICARE COMPLETE HMO