| East Georgia Healthcare Center Inc | |
|
4357 E Louisiana Ave Soperton GA 30457-3661 | |
| (478) 488-4234 | |
| (478) 237-9138 |
| Full Name | East Georgia Healthcare Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4357 E Louisiana Ave, Soperton, Georgia |
| Authorized Official Name and Position | Jill R Sorrells (CFO) |
| Authorized Official Contact | 4784191641 |
| 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 4357 E Louisiana Ave Soperton GA 30457-3661 Ph: (478) 488-4234 |
| NPI Number | 1700820917 |
|---|---|
| Provider Enumeration Date | 06/16/2006 |
| Last Update Date | 05/01/2023 |
| Medicare PECOS PAC ID | 0547228686 |
|---|---|
| Medicare Enrollment ID | O20041223000205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700820917 | NPI | - | NPPES |
| 000632376G | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
East Georgia Healthcare Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7892 Ga Highway 29, Soperton, GA 30457 Phone: 478-237-2638 Fax: 478-237-9138 | |
Million Pines Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 Third St, Soperton, GA 30457 Phone: 912-529-4774 Fax: 912-529-4409 |