# MT. ZION COMMUNITY REINVESTMENT CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Samaritan Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528899135
- **Authorized official:** NEDRA S FORTSON APRN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (770) 330-8496

## Contact information

- **Practice address:** 802 N JEFFERSON ST, ALBANY, GA 31701-2363
- **Practice address phone:** (229) 888-7420
- **Practice address fax:** (229) 888-7421
- **Mailing address:** 802 N JEFFERSON ST, ALBANY, GA 31701-2363
- **Mailing address phone:** (229) 888-7420
- **Mailing address fax:** (229) 888-7421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/13/2024
- **Last updated:** 08/13/2024