Organization Name:  RENEWALASC, LLC


Practice Location:
900 MOHAWK ST SUITE A SAVANNAH, GA 31419 US
Tel: 912-920-2090  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical	GA	025270

Other Provider Identifiers:

Issuer	Number	State	Type
	582173090A	GA	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin