Organization
SOUTH CENTRAL PRIMARY CARE CENTER, INC.
Active
Other names
DOUGLAS FAMILY HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT B TUCKER JR. (CEO)
(229) 468-9166
Entity
Organization
Contact information
Practice address
1309 OCILLA RD, SUITE A, DOUGLAS, GA 31533
(912) 384-2252
(912) 384-8888
Mailing address
204 E 4TH ST, OCILLA, GA 31774-1539
(229) 468-9166
(229) 468-9188
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000611663D
—
GA
Enumeration date
10/24/2006
Last updated
10/30/2024
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