Tri-County Health System, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Crawfordville, GA
NPI 1124294434 · NPPES record last updated Jun 25, 2008
Key facts
- NPI
- 1124294434
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- TRI-COUNTY HEALTH SYSTEM, INC.
- Practice address
- 156 Alexander Street
Crawfordville, GA 30631-2800 - Phone
- (706) 456-2925
- Fax
- (706) 456-2224
- NPI assigned
- May 6, 2008
- Organization subpart
- No
Authorized official
- Name
- Donna Newsome
- Title
- Ceo
- Phone
- (706) 465-3253
Practitioners 16
-
Wiiliam G Caput, MD
-
Kelli M Carter, M.D.
-
Lushunda M Hurst, P.A.
-
Miek C. Johnson, PA
-
Shamim Ara Mohammad, P.A.
-
Wendell Smith, MD
-
Lisa D Jennings, MD
-
Faheem B Nusrat, MD
-
Michael Smith, M.D.
-
Mark E Taylor, MD
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
156 Alexander Street
Crawfordville, GA 30631-2800
Mailing address
PO Box 312
Warrenton, GA 30828-0312
Phone (706) 465-3253
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000215982E | Other | GA | MEDICAID FFS |
| 08BBSCL | Other | GA | MEDICARE FFS |
| 08BDFLS | Other | GA | MEDICARE FFS |
| 000302068K | Other | GA | MEDICAID FFS |
| 000471809C | Other | GA | MEDICAID FQHC |
| 08BDMNG | Other | GA | MEDICARE FFS |
| 000308228C | Other | GA | MEDICAID FFS |
| 000060387T | Other | GA | MEDICAID FFS |
| 08BDFZD | Other | GA | MEDICARE FFS |
| 980939645G | Other | GA | MEDICAID FFS |
| GRP1619 | Other | GA | MEDICARE FFS |
| 08BBWTQ | Other | GA | MEDICARE FFS |
Other providers in Crawfordville, GA
- Tiesha Owens
- Kenya Johnson Smith
- Taliaferro County Board of Education
- Taliaferro County Board of Health
- Taliaferro County Board of Health
All providers in Crawfordville, GA · Federally Qualified Health Center (FQHC) in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.