| Mountain Valley Medical Center | |
|
92 Bettys Creek Rd Dillard GA 30537-2257 | |
| (706) 746-6571 | |
| (706) 746-5643 |
| Full Name | Mountain Valley Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 92 Bettys Creek Rd, Dillard, Georgia |
| Authorized Official Name and Position | Carlie Suzanne Pennington (OFFICE MANAGER) |
| Authorized Official Contact | 7067466571 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Valley Medical Center Po Box 444 Dillard GA 30537-0444 Ph: (706) 746-6571 | Mountain Valley Medical Center 92 Bettys Creek Rd Dillard GA 30537-2257 Ph: (706) 746-6571 |
| NPI Number | 1134316219 |
|---|---|
| Provider Enumeration Date | 10/02/2007 |
| Last Update Date | 05/30/2024 |
| Medicare PECOS PAC ID | 7416035977 |
|---|---|
| Medicare Enrollment ID | O20080710000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134316219 | NPI | - | NPPES |
| 000273831G | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 025380 (Georgia) | Primary |
| Provider Name | Charles R Pennington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669589594 PECOS PAC ID: 1759369135 Enrollment ID: I20071130000073 |
Mountain Valley Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 92 Bettys Creek Rd, Dillard, GA 30537 Phone: 706-746-6571 Fax: 706-746-5643 | |
Mountain Valley Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 92 Bettys Creek Rd, Dillard, GA 30537 Phone: 706-746-6571 Fax: 706-746-5643 |