| East Georgia Healthcare Center, Inc. | |
|
117 Memorial Dr Reidsville GA 30453-4641 | |
| (912) 557-3300 | |
| (912) 557-3328 |
| Full Name | East Georgia Healthcare Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 117 Memorial Dr, Reidsville, Georgia |
| Authorized Official Name and Position | Jennie Wren Denmark (CEO) |
| Authorized Official Contact | 4782372638 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Georgia Healthcare Center, Inc. 215 N Coleman St Swainsboro GA 30401-3530 Ph: (478) 237-2638 | East Georgia Healthcare Center, Inc. 117 Memorial Dr Reidsville GA 30453-4641 Ph: (912) 557-3300 |
| NPI Number | 1093754905 |
|---|---|
| Provider Enumeration Date | 06/06/2006 |
| Last Update Date | 07/31/2015 |
| Medicare PECOS PAC ID | 0547228686 |
|---|---|
| Medicare Enrollment ID | O20041221000771 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093754905 | NPI | - | NPPES |
| 000632376F | Medicaid | GA | |
| 111887 | Other | MEDICARE PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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