| |
275 First Street Extention Springfield GA 31329 | |
(912) 754-3040 | |
(912) 754-7108 |
Full Name | |
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Speciality | Counselor |
Location | 275 First Street Extention, Springfield, Georgia |
Authorized Official Name and Position | Rachel Skinner (DIRECTOR OF REIMBURSEMENT) |
Authorized Official Contact | 9125548498 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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700 Coastal Village Dr Brunswick GA 31520-1974 Ph: (912) 554-8510 | 275 First Street Extention Springfield GA 31329 Ph: (912) 754-3040 |
NPI Number | 1003945627 |
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Provider Enumeration Date | 03/02/2007 |
Last Update Date | 11/14/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003945627 | NPI | - | NPPES |
000622553AU | Medicaid | GA | |
000714689A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |