Organization Name: | SMITH RURAL HEALTH CLINIC |
NPI Number: | 1285637728 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBORAH S WILLIAMSON (CLINIC ADMINISTRATOR) |
Mailing Address: | 114 S Jefferson St Swainsboro |
State: | GA US |
Postal Code: | 304013146 |
Phone Number: | 4782377517 |
Fax Number: | 4782374299 |
NPI Enumeration Date: | 05/29/2005 |
NPI Last Update Date: | 07/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | 113829 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |