| Organization Name: | LONG COUNTY HEALTH CENTER |
| NPI Number: | 1528298668 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH P IERARDI (CEO) |
| Mailing Address: | 40 E Cypress St Bldg A Ludowici |
| State: | GA US |
| Postal Code: | 31316 |
| Phone Number: | 9123024067 |
| Fax Number: | 9123024068 |
| NPI Enumeration Date: | 07/23/2009 |
| NPI Last Update Date: | 07/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |