Organization
EAST GEORGIA HEALTHCARE CENTER INC
Active
Other names
Statesboro Pediatrics & Family Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
JILL R SORRELLS (CFO)
(478) 237-6262
Entity
Organization
Contact information
Practice address
1570 BRAMPTON AVENUE, STATESBORO, GA 30458-0855
(478) 764-9196
(912) 764-8401
Mailing address
215 N COLEMAN ST, SWAINSBORO, GA 30401-3530
(478) 237-6262
(478) 237-9138
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003108558A
—
GA
Enumeration date
10/22/2009
Last updated
11/21/2014
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