Organization
PRIMARY HEALTH CARE CENTER OF DADE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BUFFINGTON (CREDENTIALING DIRECTOR)
(706) 620-4494
Entity
Organization
Contact information
Practice address
10 PROBASCO ST UNIT 214, LA FAYETTE, GA 30728-2316
(706) 719-0888
(706) 657-5885
Mailing address
13570 N MAIN ST, TRENTON, GA 30752-2012
(706) 956-2665
(706) 657-5885
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/30/2020
Last updated
12/10/2020
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