| |
1221 E Mcpherson Ave Nashville GA 31639-2326 | |
(229) 433-8600 | |
Not Available |
Full Name | |
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Speciality | Psychiatric Unit |
Location | 1221 E Mcpherson Ave, Nashville, Georgia |
Authorized Official Name and Position | Julie W Hodges (CONTROLLER) |
Authorized Official Contact | 2292594140 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 9 Valdosta GA 31603-0009 Ph: () - | 1221 E Mcpherson Ave Nashville GA 31639-2326 Ph: (229) 433-8600 |
NPI Number | 1497521801 |
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Provider Enumeration Date | 11/27/2023 |
Last Update Date | 11/29/2023 |
Certification Date | 11/29/2023 |
Medicare PECOS PAC ID | 1052764677 |
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Medicare Enrollment ID | O20240410003462 |
Identifier | Type | State | Issuer |
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1497521801 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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