East Georgia Healthcare Center Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Swainsboro, GA

NPI 1972160422 · NPPES record last updated May 21, 2019

Key facts

NPI
1972160422
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
EAST GEORGIA HEALTHCARE CENTER INC
Practice address
206 N Green St
Swainsboro, GA 30401-3218
Phone
(478) 237-7948
Fax
(478) 237-9138
NPI assigned
May 21, 2019
Organization subpart
No

Authorized official

Name
Jill R Sorrells
Title
Cfo
Phone
(478) 237-6262

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050722000569 GA Part B Supplier - Clinic/Group Practice 0547228686 Receives reassigned benefits from 49 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wadley, GA; Vidalia, GA; Sylvania, GA; Swainsboro, GA; Mount Vernon, GA; Stillmore, GA; Statesboro, GA; Soperton, GA…

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

206 N Green St
Swainsboro, GA 30401-3218

Mailing address

215 N Coleman St
Swainsboro, GA 30401-3530
Phone (478) 237-2638

Other names

  • Haddock Chiropractic Former legal business name

Other providers in Swainsboro, GA

All providers in Swainsboro, GA · Federally Qualified Health Center (FQHC) in Georgia

Sources for this page

Verify at the official NPI Registry.