Organization
SOUTH CENTRAL PRIMARY CARE CENTER, INC
Active
Other names
VALDOSTA INTERNAL MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BONDS TUCKER (CEO)
(229) 468-9166
Entity
Organization
Contact information
Practice address
3308 GREYSTONE WAY, VALDOSTA, GA 31605-1096
(229) 468-9166
(229) 468-9188
Mailing address
PO BOX 749, OCILLA, GA 31774-0749
(229) 468-9166
(229) 468-9188
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/29/2021
Last updated
11/26/2024
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