Organization
RURAL HEALTH CENTER OF SOUTHEAST GA.,INC.
Active
Other names
family health center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN BURTON DERRICK (CEO)
(912) 538-0830
Entity
Organization
Contact information
Practice address
300 ARLINGTON DR., VIDALIA, GA 30474
(912) 538-0830
(912) 538-1333
Mailing address
300 ARLINGTON DR., PO BOX 645, VIDALIA, GA 30475-0645
(912) 538-0830
(912) 538-1333
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00741243A
—
GA
Enumeration date
01/22/2007
Last updated
01/28/2008
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