Organization
EAST GEORGIA HEALTHCARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL R SORRELLS (CFO)
(478) 237-6262
Entity
Organization
Contact information
Practice address
118 E BROAD ST, MOUNT VERNON, GA 30445-3018
(478) 237-2638
(478) 237-9138
Mailing address
128 S MAIN ST, SWAINSBORO, GA 30401-3618
(478) 237-6262
(478) 237-6221
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000632376K
—
GA
Enumeration date
01/23/2009
Last updated
08/04/2014
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