Edison Medical Center | |
19519 Hartford St Edison GA 39846-5803 | |
(229) 835-2238 | |
(229) 835-3032 |
Full Name | Edison Medical Center |
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Speciality | Clinic/Center |
Location | 19519 Hartford St, Edison, Georgia |
Authorized Official Name and Position | Shelley Spires (CEO) |
Authorized Official Contact | 2298886559 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Edison Medical Center 204 N Westover Blvd Albany GA 31707-2983 Ph: (229) 835-2238 | Edison Medical Center 19519 Hartford St Edison GA 39846-5803 Ph: (229) 835-2238 |
NPI Number | 1366477838 |
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Provider Enumeration Date | 07/12/2006 |
Last Update Date | 09/21/2016 |
Medicare PECOS PAC ID | 7911811922 |
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Medicare Enrollment ID | O20050920001108 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366477838 | NPI | - | NPPES |
000674737B | Medicaid | GA | |
000674737A | Medicaid | GA | |
CG1481 | Other | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |