| Rural Hiv Model Thomasville | |
|
14540 Us Hwy 19 S Ste#1 Thomasville GA 31757 | |
| (229) 225-3996 | |
| (229) 436-4107 |
| Full Name | Rural Hiv Model Thomasville |
|---|---|
| Speciality | Clinic/Center |
| Location | 14540 Us Hwy 19 S Ste#1, Thomasville, Georgia |
| Authorized Official Name and Position | Shelley Spires (CEO) |
| Authorized Official Contact | 2298886559 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rural Hiv Model Thomasville 204 N. Westover Blvd. Albany GA 31707-2983 Ph: (229) 888-6559 | Rural Hiv Model Thomasville 14540 Us Hwy 19 S Ste#1 Thomasville GA 31757 Ph: (229) 225-3996 |
| NPI Number | 1235489683 |
|---|---|
| Provider Enumeration Date | 09/13/2012 |
| Last Update Date | 08/21/2018 |
| Medicare PECOS PAC ID | 7911811922 |
|---|---|
| Medicare Enrollment ID | O20130506000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235489683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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