Organization Name: | SOUTHWEST GEORGIA HEALTH CARE, INC. |
NPI Number: | 1538422977 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA YOUNG (SECRETARY) |
Mailing Address: | 218 Ga Highway 49 N Suite A Byron |
State: | GA US |
Postal Code: | 310084042 |
Phone Number: | 2292738881 |
Fax Number: | 2292738985 |
NPI Enumeration Date: | 06/20/2012 |
NPI Last Update Date: | 06/20/2012 |
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: |