| |
1570 Brampton Avenue Statesboro GA 30458-0855 | |
(478) 764-9196 | |
(912) 764-8401 |
Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1570 Brampton Avenue, Statesboro, Georgia |
Authorized Official Name and Position | Jill R Sorrells (CFO) |
Authorized Official Contact | 4782376262 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
215 N Coleman St Swainsboro GA 30401-3530 Ph: (478) 237-6262 | 1570 Brampton Avenue Statesboro GA 30458-0855 Ph: (478) 764-9196 |
NPI Number | 1225364524 |
---|---|
Provider Enumeration Date | 10/22/2009 |
Last Update Date | 11/21/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225364524 | NPI | - | NPPES |
003108558A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
East Georgia Urgent Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4451 Country Club Rd, Suite 3a, Statesboro, GA 30459 Phone: 912-764-2273 | |
Gastroenterology Institute, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 Hill Pond Ln, Statesboro, GA 30458 Phone: 912-681-6944 Fax: 912-681-8744 | |
Brian A Moogerfeld Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1088a Bermuda Run, Statesboro, GA 30458 Phone: 912-681-7111 Fax: 912-871-7794 | |