Organization
PRIMARY HEALTH CARE CENTER OF DADE, INC.
Active
Other names
PRIMARY HEALTH CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY L BUFFINGTON (CREDENTIALING COORDINATOR)
(706) 956-2665
Entity
Organization
Contact information
Practice address
2009 OLD LAFAYETTE RD, FORT OGLETHORPE, GA 30742-3510
(706) 866-5520
(706) 866-5502
Mailing address
13570 N MAIN ST, TRENTON, GA 30752-2012
(706) 657-7575
(706) 657-5885
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000211956C
—
GA
Enumeration date
11/20/2007
Last updated
09/22/2022
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