Organization
J C LEWIS PRIMARY HEALTH CARE CENTER INC
Active
Parent organization
J C LEWIS PRIMARY HEALTH CARE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
J C LEWIS PRIMARY HEALTH CARE CENTER
Authorized official
GWENDOLYN LOWE (CHIEF FINANCIAL OFFICER)
(912) 721-6705
Entity
Organization
Contact information
Practice address
2414 BULL ST, SAVANNAH, GA 31401-9113
(912) 495-8887
(912) 495-8881
Mailing address
PO BOX 13577, SAVANNAH, GA 31416-0577
(912) 495-8887
(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
—
003122855A
—
GA
01
—
111979
MEDICARE PART A
GA
01
—
202G701304
MEDICARE PART B
GA
Enumeration date
07/15/2016
Last updated
02/27/2023
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