| Primary Care Of Southwest Georgia, Inc | |
|
916 S Broad St Unit B-2 Thomasville GA 31792-6113 | |
| (229) 226-8800 | |
| (229) 226-2036 |
| Full Name | Primary Care Of Southwest Georgia, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 916 S Broad St, Thomasville, Georgia |
| Authorized Official Name and Position | Edwin James (CFO) |
| Authorized Official Contact | 2297232660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Of Southwest Georgia, Inc Po Box 1479 Thomasville GA 31799-1479 Ph: (229) 226-8800 | Primary Care Of Southwest Georgia, Inc 916 S Broad St Unit B-2 Thomasville GA 31792-6113 Ph: (229) 226-8800 |
| NPI Number | 1992102073 |
|---|---|
| Provider Enumeration Date | 12/04/2014 |
| Last Update Date | 04/06/2015 |
| Medicare PECOS PAC ID | 5496777948 |
|---|---|
| Medicare Enrollment ID | O20150917002719 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992102073 | NPI | - | NPPES |
| 003155529A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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