NPI 1245519511

Rehoboth Miracle LLC

Organisation Exclusive Provider Organization Covington, GA

Practice location

Address: 140 Shiver Blvd, Covington, GA 30016-1399
Phone: (678) 712-6073

Authorised official

Name: Debrah Olive Ann Ramsay
Title: President
Phone: (678) 712-6073

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 107 R 0894 (GA)

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Registry record

NPI: 1245519511
Entity type: Organization
NPI issued: 4 Aug 2011
Record last updated: 4 Aug 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.