Organization Name: | SOUTHWEST GEORGIA HEALTH CARE, INC |
NPI Number: | 1225228307 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA J. YOUNG (ADMINISTRATIVE SECRETARY) |
Mailing Address: | 618 East Lamar Street Americus |
State: | GA US |
Postal Code: | 317093738 |
Phone Number: | 2299284755 |
Fax Number: | 2299284750 |
NPI Enumeration Date: | 07/26/2007 |
NPI Last Update Date: | 04/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |