Organization
BACCHUS OPERATIONS GROUP, INC.
Active
Other names
Flint River Rural Health Clinic - Oglethorpe
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL C PATTERSON (CHIEF EXECUTIVE OFFICER)
(478) 472-3100
Entity
Organization
Contact information
Practice address
502 SUMTER ST, MONTEZUMA, GA 31063-1734
(478) 472-8178
(478) 472-3289
Mailing address
509 SUMTER ST, P.O. BOX 770 (31063-2502), MONTEZUMA, GA 31063-1733
(478) 472-3100
(478) 472-3248
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00014987C
—
GA
Enumeration date
10/11/2006
Last updated
06/10/2014
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