| Jenkins County Medical Center | |
|
931 E Winthrope Ave Millen GA 30442-1839 | |
| (478) 982-4221 | |
| (478) 982-1224 |
| Full Name | Jenkins County Medical Center |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 931 E Winthrope Ave, Millen, Georgia |
| Authorized Official Name and Position | Antoine Poythress (CEO) |
| Authorized Official Contact | 4789824221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jenkins County Medical Center 931 E Winthrope Ave Millen GA 30442-1839 Ph: (478) 982-4221 | Jenkins County Medical Center 931 E Winthrope Ave Millen GA 30442-1839 Ph: (478) 982-4221 |
| NPI Number | 1902453111 |
|---|---|
| Provider Enumeration Date | 08/22/2019 |
| Last Update Date | 05/05/2021 |
| Certification Date | 05/05/2021 |
| Medicare PECOS PAC ID | 8224368394 |
|---|---|
| Medicare Enrollment ID | O20210325000501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902453111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
| Provider Name | David P Samuels |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942333158 PECOS PAC ID: 7113814229 Enrollment ID: I20040303000412 |
| Provider Name | Solange Marie Marcel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679602536 PECOS PAC ID: 9335200153 Enrollment ID: I20081211000207 |
| Provider Name | Kemaya L Wilburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841675667 PECOS PAC ID: 3779893052 Enrollment ID: I20151117002461 |
| Provider Name | Holly Hollis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063996577 PECOS PAC ID: 5092050633 Enrollment ID: I20181229000034 |
Community Service Board Of Middle Georgia Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 Old Sylvania Rd, Millen, GA 30442 Phone: 478-982-5954 Fax: 478-982-3086 | |
Ogeechee Behavioral Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 Old Sylvania Rd, Millen, GA 30442 Phone: 478-982-5954 Fax: 478-982-3086 | |
Hospital Authority Of Jenkins County Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 931 E Winthrope Ave, Millen, GA 30442 Phone: 478-982-4221 | |
Ogeechee Behavioral Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 727 Virginia Avenue, Millen, GA 30442 Phone: 478-982-2137 Fax: 478-982-2595 | |
Community Service Board Of Middle Georgia Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 Old Sylvania Rd, Millen, GA 30442 Phone: 478-982-5954 Fax: 478-982-3086 | |
Ogeechee Behavioral Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 Old Sylvania Rd, Millen, GA 30442 Phone: 478-982-5954 |