| Phoebe Sumter Ellaville Clinic | |
|
339 S Broad St Ellaville GA 31806-3304 | |
| (229) 937-5321 | |
| (229) 937-2232 |
| Full Name | Phoebe Sumter Ellaville Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 339 S Broad St, Ellaville, Georgia |
| Authorized Official Name and Position | Brandi Lunneborg (CEO) |
| Authorized Official Contact | 2299311191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoebe Sumter Ellaville Clinic Po Box 65 Ellaville GA 31806-9228 Ph: (229) 937-5321 | Phoebe Sumter Ellaville Clinic 339 S Broad St Ellaville GA 31806-3304 Ph: (229) 937-5321 |
| NPI Number | 1376778001 |
|---|---|
| Provider Enumeration Date | 05/26/2009 |
| Last Update Date | 02/14/2018 |
| Medicare PECOS PAC ID | 4385789213 |
|---|---|
| Medicare Enrollment ID | O20100303000842 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376778001 | NPI | - | NPPES |
| 003112355A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Georgia) | Primary |
Ellaville Primary Medicine Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 72 S Broad St, Ellaville, GA 31806 Phone: 229-937-5321 Fax: 229-937-2232 | |
Careconnect Convenient Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 41 East Oglethorpe Street, Ellaville, GA 31806 Phone: 229-937-9003 Fax: 229-937-9007 | |
Ellaville Primary Medicine Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 72 S. Broad St., Ellaville, GA 31806 Phone: 229-937-5321 Fax: 229-937-2232 | |
Southwest Ga Primary Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 93 S Broad St, Ellaville, GA 31806 Phone: 229-410-9965 Fax: 229-937-9007 |