Organization Name: | MCKINNEY COMMUNITY HEALTH CTR, INC |
NPI Number: | 1801057690 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | OLA SMITH (CEO) |
Mailing Address: | 3919 Main St Folkston |
State: | GA US |
Postal Code: | 315377545 |
Phone Number: | 9124963426 |
Fax Number: | 9122871568 |
NPI Enumeration Date: | 06/24/2008 |
NPI Last Update Date: | 02/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | 111908 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |