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115 Gillikin St Twin City GA 30471-3989 | |
(478) 763-3036 | |
(478) 763-4060 |
Full Name | |
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Speciality | Clinic/Center |
Location | 115 Gillikin St, Twin City, Georgia |
Authorized Official Name and Position | Steve King (CFO) |
Authorized Official Contact | 4782891376 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 879 Swainsboro GA 30401-0879 Ph: (478) 289-1303 | 115 Gillikin St Twin City GA 30471-3989 Ph: (478) 763-3036 |
NPI Number | 1912319997 |
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Provider Enumeration Date | 05/27/2014 |
Last Update Date | 09/23/2015 |
Medicare PECOS PAC ID | 3577473040 |
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Medicare Enrollment ID | O20150325001434 |
Identifier | Type | State | Issuer |
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1912319997 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |