PRIMARY CARE OF SOUTHWEST GEORGIA INC. NPI 1366641318

NPI Information

NPI: 1366641318
Provider Name: PRIMARY CARE OF SOUTHWEST GEORGIA, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
454 SMITH AVE
THOMASVILLE, GA
ZIP 31792
Phone: (229) 227-5510
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PRIMARY CARE OF SOUTHWEST GEORGIA, INC. is a federally qualified health center (fqhc) clinic center in Thomasville, GA. PRIMARY CARE OF SOUTHWEST GEORGIA, INC. NPI is 1366641318. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

454 SMITH AVE
THOMASVILLE, GA
ZIP 31792-535
Phone: (229) 227-5510
Fax: (229) 227-5527

The provider's authorized official is Angela Mcvey .
The authorized official title is Ceo and has the following contact phone number (229) 723-2660.

The enumeration date for this NPI number is 7/11/2007 and was last updated on 3/3/2022.

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	207Q00000X	Family Medicine				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	024893266C	MEDICAID	GEORGIA

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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