East Georgia Healthcare Center, Inc.

NPI #1790924918 in Vidalia, Georgia

Provider Information

NPI Number: 1790924918
Entity Type: Organization
Organization Name: East Georgia Healthcare Center, Inc.
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Feb 11, 2009
Last Updated: Aug 26, 2015

Practice Location

Address: 118 ALICE COLEMAN DR
City: Vidalia
State: Georgia
ZIP Code: 30474-8860
Phone: (912) 537-6565

Authorized Official

Name: JILL R SORRELLS
Title: CFO
Phone: (478) 237-6262

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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