| Gerdie And Louise Pch | |
|
104 Robbins St Sylvania GA 30467-2532 | |
| (912) 515-5030 | |
| Not Available |
| Full Name | Gerdie And Louise Pch |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 104 Robbins St, Sylvania, Georgia |
| Authorized Official Name and Position | Jusitne Taylor Lewis (OWNER) |
| Authorized Official Contact | 9125155030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gerdie And Louise Pch 106 Harden Rd Statesboro GA 30458-2717 Ph: (912) 515-5030 | Gerdie And Louise Pch 104 Robbins St Sylvania GA 30467-2532 Ph: (912) 515-5030 |
| NPI Number | 1821388133 |
|---|---|
| Provider Enumeration Date | 04/08/2011 |
| Last Update Date | 04/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821388133 | NPI | - | NPPES |
| 996863388A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 121010101 (Georgia) | Primary |
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