Southern Heritage | |
814 Carl Vinson Pkwy Centerville GA 31028-1421 | |
(478) 922-6380 | |
Not Available |
Full Name | Southern Heritage |
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Speciality | Clinic/center |
Location | 814 Carl Vinson Pkwy, Centerville, Georgia |
Authorized Official Name and Position | Anica G Hollar (ADMINISTRATOR) |
Authorized Official Contact | 4789226380 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southern Heritage 814 Carl Vinson Pkwy Centerville GA 31028-1421 Ph: (478) 922-6380 | Southern Heritage 814 Carl Vinson Pkwy Centerville GA 31028-1421 Ph: (478) 922-6380 |
NPI Number | 1932503299 |
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Provider Enumeration Date | 10/15/2014 |
Last Update Date | 10/15/2014 |
Identifier | Type | State | Issuer |
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1932503299 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |