South Central Family Medicine

LBN: South Central Primary Care Center, Inc
South Central Family Medicine is an health care organization with primary practice located at 640 Main St N , Pearson GA 31642. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. South Central Primary Care Center, Inc can be contacted via phone (912) 544-4569, or through Tucker, Robert B via phone (229) 468-9166.

Contact Information

Primary practice address
640 Main St N Pearson GA 31642
Phone: (912) 544-4569
Fax: (912) 422-3180
Website:
Map and Directions
Authorized official contact:
Name: Tucker, Robert B
Phone: (229) 468-9166

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X Georgia

Profile Details

NPI number 1558445742
LBN Legal business name South Central Primary Care Center, Inc
DBA Doing business as South Central Family Medicine
Authorized official Tucker, Robert B
Entity Organization
Organization subpart 1 No
Enumeration date Oct 24th, 2006
Last updated Feb 11th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558445742 NPPES
Georgia MEDICAID 000611663F

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