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206 E Church St Bowman GA 30624-2109 | |
(706) 245-7361 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 206 E Church St, Bowman, Georgia |
Authorized Official Name and Position | David Ward (CEO) |
Authorized Official Contact | 7067883234 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 459 Colbert GA 30628-0459 Ph: () - | 206 E Church St Bowman GA 30624-2109 Ph: (706) 245-7361 |
NPI Number | 1235249236 |
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Provider Enumeration Date | 08/30/2006 |
Last Update Date | 05/03/2022 |
Medicare PECOS PAC ID | 3274442850 |
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Medicare Enrollment ID | O20050506000332 |
Identifier | Type | State | Issuer |
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1235249236 | NPI | - | NPPES |
000471765B | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |