| Statewide Health Care Inc | |
|
102 Oglethorpe Professional Ct Suite 4 Savannah GA 31406-3600 | |
| (912) 231-8958 | |
| (912) 234-7701 |
| Full Name | Statewide Health Care Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 102 Oglethorpe Professional Ct, Savannah, Georgia |
| Authorized Official Name and Position | J Craig Gordon (CEO) |
| Authorized Official Contact | 9122318958 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Statewide Health Care Inc 102 Oglethorpe Professional Ct Suite 4 Savannah GA 31406-3600 Ph: (912) 231-8958 | Statewide Health Care Inc 102 Oglethorpe Professional Ct Suite 4 Savannah GA 31406-3600 Ph: (912) 231-8958 |
| NPI Number | 1295279495 |
|---|---|
| Provider Enumeration Date | 12/07/2016 |
| Last Update Date | 12/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295279495 | NPI | - | NPPES |
| 000621288A | Medicaid | GA | |
| 000510243C | Medicaid | GA | |
| 000510243D | Medicaid | GA | |
| 000510529B | Medicaid | GA | |
| 000510529AA | Medicaid | GA | |
| 000510243B | Medicaid | GA | |
| 000510529Y | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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