PRIMARY HEALTH CARE CENTER OF DADE INC. NPI 1235505678

NPI Information

NPI: 1235505678
Provider Name: PRIMARY HEALTH CARE CENTER OF DADE, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 11D1081884

Address:
87 S BURNT MILL RD
LA FAYETTE, GA
ZIP 30728
Phone: (706) 620-4494
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PRIMARY HEALTH CARE CENTER OF DADE, INC. is a federally qualified health center (fqhc) clinic center in La Fayette, GA. PRIMARY HEALTH CARE CENTER OF DADE, INC. NPI is 1235505678. The provider is registered as an organization entity type.

The provider's business location address is:

87 S BURNT MILL RD
LA FAYETTE, GA
ZIP 30728-263
Phone: (706) 620-4494
Fax: (706) 620-2379

The provider's authorized official is Diana Allen .
The authorized official title is Ceo and has the following contact phone number (706) 620-4494.

The CLIA number assigned to this NPI record is 11D1081884 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/20/2015 and was last updated on 8/20/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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