Organization
SOUTH CENTRAL PRIMARY CARE CENTER, INC
Active
Other names
NORTHSIDE FAMILY HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT B TUCKER JR. (CEO)
(229) 468-9166
Entity
Organization
Contact information
Practice address
247 NORTHSIDE DR STE B, VALDOSTA, GA 31602
(229) 253-1206
(229) 253-1209
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
06/26/2018
Last updated
11/26/2024
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