Organization
VIDALIA WOMEN'S CENTER, LLC
Active
Parent organization
SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Other names
Vidalia Women's Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Authorized official
TONY M OSTEEN (CFO)
(912) 538-5314
Entity
Organization
Contact information
Practice address
101 HARRIS INDUSTRIAL BLVD., SUITE C, VIDALIA, GA 30474-8845
(912) 537-1014
(912) 538-0979
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(912) 537-1014
(912) 538-0979
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/21/2007
Last updated
08/28/2019
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