Organization
FOUR CORNERS PRIMARY CARE CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN A JOHNSON (CFO)
(770) 279-3142
Entity
Organization
Contact information
Practice address
175 GWINNETT DR, SUITE 213, LAWRENCEVILLE, GA 30046-8444
(770) 279-3142
(770) 234-5210
Mailing address
5030 GEORGIA BELLE CT, SUITE 2066, NORCROSS, GA 30093-2667
(770) 279-3142
(770) 234-5210
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/06/2013
Last updated
09/27/2013
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