Organization
J C LEWIS PRIMARY HEALTHCARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA WRIGHT (CREDENTIALING)
(912) 721-6704
Entity
Organization
Contact information
Practice address
3802 WATERS AVE, SAVANNAH, GA 31404-6210
(912) 352-3845
(912) 354-1980
Mailing address
5 MALL ANX, SAVANNAH, GA 31406-4738
(912) 721-6704
(912) 495-8881
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003104809A
—
GA
Enumeration date
07/19/2016
Last updated
11/08/2023
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