Coolidge Primary Care Clinic

LBN: John D. Archbold Memorial Hospital, Inc.
Coolidge Primary Care Clinic is an health care organization with primary practice located at 1034 South Pine Street , Coolidge GA 31738. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. John D. Archbold Memorial Hospital, Inc. can be contacted via phone (229) 346-3511, or through Hightower, Charles D. via phone (229) 228-2853.

Contact Information

Primary practice address
1034 South Pine Street Coolidge GA 31738
Phone: (229) 346-3511
Fax: (229) 346-3512
Website:
Map and Directions
Authorized official contact:
Name: Hightower, Charles D.
Phone: (229) 228-2853

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X 136-91 Georgia

Profile Details

NPI number 1114014669
LBN Legal business name John D. Archbold Memorial Hospital, Inc.
DBA Doing business as Coolidge Primary Care Clinic
Authorized official Hightower, Charles D.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 6th, 2006
Last updated May 7th, 2008 - about 17 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 1114014669 NPPES
Georgia MEDICAID 000000063F

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