Primary Health Care Center Of Dade, Inc. | |
87 S Burnt Mill Rd La Fayette GA 30728-4263 | |
(706) 620-4494 | |
(706) 657-2958 |
Full Name | Primary Health Care Center Of Dade, Inc. |
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Speciality | Clinic/Center |
Location | 87 S Burnt Mill Rd, La Fayette, Georgia |
Authorized Official Name and Position | Diana U Allen (CEO) |
Authorized Official Contact | 7066204494 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primary Health Care Center Of Dade, Inc. 13570 N Main St Trenton GA 30752-2012 Ph: (706) 956-2665 | Primary Health Care Center Of Dade, Inc. 87 S Burnt Mill Rd La Fayette GA 30728-4263 Ph: (706) 620-4494 |
NPI Number | 1356715452 |
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Provider Enumeration Date | 11/30/2015 |
Last Update Date | 11/30/2015 |
Medicare PECOS PAC ID | 0547272650 |
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Medicare Enrollment ID | O20160112002133 |
Identifier | Type | State | Issuer |
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1356715452 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Primary Health Care Center Of Dade, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 87 S Burnt Mill Rd, La Fayette, GA 30728 Phone: 706-620-4494 Fax: 706-620-2379 | |
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