Organization
LOWER OCONEE COMMUNITY HOSPITAL, INC
Active
Organization
LOWER OCONEE COMMUNITY HOSPITAL, INC
Active
Other names
MONTGOMERY INTERNAL MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
LYNAN FOWLER (BUSINESS OFFICE)
(912) 523-5113
Entity
Organization
Contact information
Practice address
441 W BROAD STREET, MOUNT VERNON, GA 30445-2629
(912) 583-2229
Mailing address
441 W BROAD STREET, PO BOX 546, MOUNT VERNON, GA 30445-2629
(912) 583-2229
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
208152021
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324829478B
—
GA
Enumeration date
03/20/2007
Last updated
07/11/2013
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