Organization
JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.
Active
Other names
Coolidge Primary Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES D. HIGHTOWER JR. (CFO)
(229) 228-2853
Entity
Organization
Contact information
Practice address
1034 SOUTH PINE STREET, COOLIDGE, GA 31738
(229) 346-3511
(229) 346-3512
Mailing address
920 CAIRO RD, THOMASVILLE, GA 31792-4255
(229) 228-8800
(229) 228-8892
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
136-91
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000063F
—
GA
Enumeration date
10/06/2006
Last updated
05/07/2008
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