| J C Lewis Primary Health Care Center, Inc | |
|
3100 Montgomery St Savannah GA 31405-3212 | |
| (912) 495-8887 | |
| (912) 495-8881 |
| Full Name | J C Lewis Primary Health Care Center, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3100 Montgomery St, Savannah, Georgia |
| Authorized Official Name and Position | Laura Adams (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9124958887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J C Lewis Primary Health Care Center, Inc 125 Fahm St Savannah GA 31401-2391 Ph: (912) 495-8887 | J C Lewis Primary Health Care Center, Inc 3100 Montgomery St Savannah GA 31405-3212 Ph: (912) 495-8887 |
| NPI Number | 1184077018 |
|---|---|
| Provider Enumeration Date | 07/15/2016 |
| Last Update Date | 07/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184077018 | NPI | - | NPPES |
| 003122845A | Medicaid | GA | |
| 111961 | Other | GA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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