OLD MOULTRIE SURGICAL CENTER INC
Ambulatory Health at Old Moultrie Rd, Saint Augustine, FL

License number
Florida 1089
Category
Ambulatory Health
Type
Ambulatory Surgical
Owner
Name: GEORGE EDWARD SADOWSKI MD
Title: MEDICAL DIRECTOR
Phone: (904) 797-6627
Address
Address
2460 Old Moultrie Rd SUITE 3, Saint Augustine, FL 32086
National Provider ID: 1144326307
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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OLD MOULTRIE SURGICAL CENTER, INC

Saint Augustine, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
Old Moultrie Surgical Ctr
Registration:
Sep 1, 1998
Addresses:
2460 Old Moultrie Rd #3, Saint Augustine, FL 32086 (Physical)
Saint Augustine, FL 32085 (Mailing)
PO Box 3127, Saint Augustine, FL 32085
State ID:
P98000076306
Business type:
Florida Profit Corporation
Medical Director, President:
George Sadowski (Medical Director, President), P.o Drawer 3127, Saint Augustine, FL 32085 (Physical)
EIN:
593572609

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