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SOUTH CENTRAL PRIMARY CARE CENTER INC NPI 1356709646


NPI Information

NPI: 1356709646
Provider Name: SOUTH CENTRAL PRIMARY CARE CENTER, INC

Doing Business As: SOUTH CENTRAL FAMILY HEALTH CARE

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 11D2232392

Address:
607C N IRWIN AVE
OCILLA, GA
ZIP 31774
Phone: (229) 468-5020
Get Directions

SOUTH CENTRAL PRIMARY CARE CENTER, INC is a federally qualified health center (fqhc) clinic center in Ocilla, GA. SOUTH CENTRAL PRIMARY CARE CENTER, INC NPI is 1356709646. The provider is registered as an organization entity type.
The provider Is Doing Business As South Central Family Health Care.

The provider's business location address is:

607C N IRWIN AVE
OCILLA, GA
ZIP 31774-009
Phone: (229) 468-5020
Fax: (229) 468-5024

The provider's authorized official is Robert B Tucker .
The authorized official title is Ceo and has the following contact phone number (229) 468-9166.

The CLIA number assigned to this NPI record is 11D2232392 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2016 and was last updated on 2/10/2020.


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
1261QF0400XClinic/CenterFederally 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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.