SMITH RURAL HEALTH CLINIC NPI 1285637728

NPI Information

NPI: 1285637728
Provider Name: SMITH RURAL HEALTH CLINIC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 11D0912801

Address:
114 S JEFFERSON ST
SWAINSBORO, GA
ZIP 30401
Phone: (478) 237-7517
Get Directions

SMITH RURAL HEALTH CLINIC is a rural health clinic center in Swainsboro, GA. SMITH RURAL HEALTH CLINIC NPI is 1285637728. The provider is registered as an organization entity type.

The provider's business location address is:

114 S JEFFERSON ST
SWAINSBORO, GA
ZIP 30401-146
Phone: (478) 237-7517
Fax: (478) 237-4299

The provider's authorized official is Deborah S Williamson .
The authorized official title is Clinic Administrator and has the following contact phone number (478) 237-7517.

The CLIA number assigned to this NPI record is 11D0912801 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/29/2005 and was last updated on 7/24/2012.

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	261QR1300X	Clinic/Center	Rural Health	113829	GEORGIA	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	034616	OTHER	GEORGIA	GA LISCENSE/AHOWARD
2	1225102908	OTHER		BCBSGA/A HOWARD
3	1225102908	OTHER		HOWARD MD NPI
4	000241689A	MEDICAID	GEORGIA
5	11BDVCZ	OTHER		MCAREPARTB/AHOWARD
6	1588662506	OTHER		MASON W SMITH PAC NPI
7	00469664G	MEDICAID	GEORGIA
8	924053	OTHER		A HOWARD UNITED HLTHCARE
9	113829	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	RHC MCR #
10	10047395	OTHER	GEORGIA	AMERIGROUP GA
11	26760	OTHER		SRHC UNITED HLTHCARE
12	10054020	OTHER	GEORGIA	AGROUP/A HOWARD
13	1023012580	OTHER		H WILDER SMITH JR PAC NPI
14	336040	OTHER	GEORGIA	WELLCARE GEORGIA
15	E91097	MEDICARE UPIN
16	GRP4242	MEDICARE PIN	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: 11/14/2023

NPI Synchronization or Removal

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