Organization
COFFEE REGIONAL MEDICAL CENTER, INC
Active
Other names
Coffee Regional First Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKI LEWIS (PRESIDENT/CEO)
(912) 384-1900
Entity
Organization
Contact information
Practice address
1301 PETERSON AVE S, STE B, DOUGLAS, GA 31533-2327
(912) 383-6966
(912) 383-5667
Mailing address
PO BOX 1287, DOUGLAS, GA 31534-1287
(912) 384-1900
(912) 383-5667
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000448D
—
GA
Enumeration date
02/13/2007
Last updated
09/23/2022
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