Organization
COLQUITT REGIONAL MED CARE CLINIC
Active
Parent organization
COLQUITT REGIONAL MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLQUITT REGIONAL MEDICAL CENTER
Authorized official
MR. JAMES R LOWRY (PRESIDENT CEO)
(229) 985-3420
Entity
Organization
Contact information
Practice address
633 VETERANS PKWY S, MOULTRIE, GA 31788-8811
(229) 890-7009
Mailing address
633 VETERANS PKWY S, MOULTRIE, GA 31788-8811
(229) 890-7009
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
035-296
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
388946
WELLCARE OF GEORGIA
GA
Enumeration date
06/26/2008
Last updated
06/26/2008
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