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Organization

FAMILY PRACTICE OF HABERSHAM PC

Active
Other names
Habersham Primary Care
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BEVERLY C CARTER (MANAGER)
(706) 754-1252
Entity
Organization

Contact information

Practice address
590 HISTORIC HWY 441 N, DEMOREST, GA 30535-1779
(706) 754-5511
(706) 754-5577
Mailing address
PO BOX 1779, DEMOREST, GA 30535-1779
(706) 754-5511
(706) 754-5577

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
032741
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GRP3078
MEDICARE GRP #
GA
Enumeration date
02/26/2007
Last updated
12/16/2008
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