Family Practice Clinic

LBN: Charlton Memorial Hospital
Family Practice Clinic is an health care organization with primary practice located at 2383 Third St , Folkston GA 31537-8917. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty. Charlton Memorial Hospital can be contacted via phone (912) 496-2697, or through Mccasland, Fatima via phone (912) 496-2697.

Contact Information

Primary practice address
2383 Third St Folkston GA 31537-8917
Phone: (912) 496-2697
Fax: (912) 496-1139
Website:
Map and Directions
Authorized official contact:
Name: Mccasland, Fatima
Phone: (912) 496-2697

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1760548002
LBN Legal business name Charlton Memorial Hospital
DBA Doing business as Family Practice Clinic
Authorized official Mccasland, Fatima
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 29th, 2006
Last updated Jul 26th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760548002 NPPES
Georgia MEDICAID 814096430A
Georgia Other HOSP45
Georgia MEDICAID 164482236A

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