Organization · Type 2 NPI
Premise Health of Georgia Medical PC
Primary Care Clinic/Center · Glennville, GA
NPI number
1114406295
Active
Practice location
801 W Barnard St
Glennville, GA 30427-3030
Fax (912) 654-2695
Mailing address
5500 Maryland Way Ste 400
Brentwood, TN 37027-7048
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | None listed |
Primary Care Clinic/Center: Definition to come...
About NPI 1114406295
Premise Health of Georgia Medical PC's National Provider Identifier is 1114406295, issued on Aug 9, 2018. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Glennville, GA. The record was last updated on Feb 2, 2026.