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Wolf Creek Ent Llc
Eyewear Supplier in Milledgeville, Georgia
NPI 1700091980

Wolf Creek Ent Llc is a Eyewear Supplier based in Milledgeville, GA. Wolf Creek Ent Llc practices in Milledgeville, GA. The NPI Number for Wolf Creek Ent Llc is 1700091980 and holds a License No. LDO001648 (Georgia).

The current practice location address for Wolf Creek Ent Llc is 1841 N Columbia St, Milledgeville, GA and can be reached out via phone at 478-452-3593 and via fax at 478-936-9992.

Location: 1841 N Columbia St, Milledgeville, GA, 31061-2382
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1700091980
Provider Name
Wolf Creek Ent Llc
Credential
Provider Entity Type
Organization
Address
1841 N Columbia St, Milledgeville, GA, 31061-2382
Phone Number
478-452-3593
Fax Number
478-936-9992
Provider Enumeration Date
05/11/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
07820 01 GA SPECTERA
100921 01 GA AVESIS MCAID
00897487A 05 GA
25391 01 GA AVESIS
institution
Provider Business Practice Location Address Details
Address
1841 N Columbia St
City
Milledgeville
State
Georgia
Zip
31061-2382
Phone Number
478-452-3593
Fax Number
478-936-9992
person
Provider Business Mailing Address Details
Address
1841 N Columbia St
City
Milledgeville
State
Georgia
Zip
31061-2382
Phone Number
478-452-3593
Fax Number
478-936-9992
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
(Georgia)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Eyewear Supplier
Speciality
-
Taxonomy
332H00000X
License No.
LDO001648 (Georgia)
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
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