Organization · Type 2 NPI

South Central Primary Care Center, Inc

Federally Qualified Health Center (FQHC) · Valdosta, GA

NPI number 1376207985 Active

Practice location

3308 Greystone Way
Valdosta, GA 31605-1096

Call (229) 468-9166 Map

Fax (229) 468-9188

Mailing address

PO Box 749
Ocilla, GA 31774-0749

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Fauzia K. Durrani, MDSpecialist Valdosta, GA NPI 1548224413

Other federally qualified health center (fqhc) providers in Valdosta

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NPI record

NPI: 1376207985
Entity type: Organization (Type 2)
Issued: Oct 29, 2021
Last updated: Nov 26, 2024
Status: Active

Other names

<unavail>
Valdosta Internal Medicine · doing business as
Valdosta Internal Medicine · doing business as

Authorized official

Robert Bonds Tucker
CEO
(229) 468-9166

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1376207985

South Central Primary Care Center, Inc's National Provider Identifier is 1376207985, issued on Oct 29, 2021. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Valdosta, GA. The record was last updated on Nov 26, 2024.