Organization
PHOEBE SUMTER MEDICAL CENTER, INC
Active
Parent organization
PHOEBE SUMTER MEDICAL CENTER, INC
Other names
Phoebe Sumter Ellaville Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOEBE SUMTER MEDICAL CENTER, INC
Authorized official
BRANDI LUNNEBORG (CEO)
(229) 931-1191
Entity
Organization
Contact information
Practice address
339 S BROAD ST, ELLAVILLE, GA 31806-3304
(229) 937-5321
(229) 937-2232
Mailing address
PO BOX 65, ELLAVILLE, GA 31806-9228
(229) 937-5321
(229) 934-2232
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003112355A
—
GA
Enumeration date
05/26/2009
Last updated
02/14/2018
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