SOUTH CENTRAL PRIMARY CARE CENTER (NPI# 1649356981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649356981 |
| Entity Type | Organization |
| Organization Name | SOUTH CENTRAL PRIMARY CARE CENTER |
| Practice Address |
200 S Cherry St Ocilla GA 31774 |
| Mailing Address |
357 Cargile Rd Ocilla GA 31774-1804 |
| Practice Telephone | 2294685911 |
| Practice Fax Number | 2294684247 |
| Mailing Telephone | 2294689160 |
| Mailing Fax Number | 2294685526 |
| Enumeration Date | 2006-10-30 |
| Last Update Date | 2009-05-19 |
| Authorized Official Name | MR. ROBERT B TUCKER JR. (CFO) |
| Authorized Official Telephone | 2294689160 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000611663G | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063840296 | South Central Primary Care Center | Clinic/Center | 303 Shirley Ave, Ste B, Douglas, GA 31533 | 2013-10-25 |
| 1538390729 | South Central Primary Care Center | Clinic/Center | 610 N Irwin Ave, Ocilla, GA 31774-0749 | 2009-08-05 |
| 1376624569 | South Central Primary Care Center | Clinic/Center | 357 Cargile Rd, Ocilla, GA 31774 | 2006-10-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SOUTH CENTRAL PRIMARY CARE CENTER, INC. | 204 E 4th St, Ocilla, GA 31774-1539 |
| Street Address |
200 S CHERRY ST |
| City | OCILLA |
| State | GA |
| Zip Code | 31774 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033595327 | Irwin County Hospital | Family Medicine | 200 S Cherry St, Ocilla, GA 31774-1804 | 2015-08-10 |
| 1891938213 | Asf Medical Center Inc | Emergency Medicine | 200 S Cherry St, Ocilla, GA 31774-1804 | 2009-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003463605 | Mary Paulk | Technician | 303 N Elm Street, Ocilla, GA 31774 | 2019-08-20 |
| 1205106903 | Tift Regional Health System Inc | Internal Medicine | 813 N. Irwin Avenue, Ocilla, GA 31774 | 2012-01-11 |
| 1497051155 | Hospice Care Options Inc | Hospice Care, Community Based | 200 S Cherry St Ste A, Ocilla, GA 31774 | 2011-01-28 |
| 1578788410 | Howard C Mcmahan Md Irwin Family Medicine Associates | Family Medicine | 361 Cargile Road, Ocilla, GA 31774 | 2007-04-16 |
| 1720150071 | Irwin County Board of Education | Local Education Agency (LEA) | 210 Apple Street, Ocilla, GA 31774 | 2006-11-14 |
| 1376624569 | South Central Primary Care Center | Clinic/Center | 357 Cargile Rd, Ocilla, GA 31774 | 2006-10-17 |
| 1508979964 | Arturo Natada Ruanto | Family Medicine | 202 South Cherry St., Ocilla, GA 31774 | 2006-08-17 |
| 1861403727 | A & H Drugs LLC | Durable Medical Equipment & Medical Supplies | 615 N. Irwin Avenue, Ocilla, GA 31774 | 2006-08-10 |
| 1285009555 | Jessica Marie Lyons | Nurse Practitioner | 361 Cargile Road, Ocilla, GA 31774 | 2015-12-11 |
| 1831231216 | Irwin County Ems | Ambulance | 108 Cotton Drive, Ocilla, GA 31774-0501 | 2007-02-13 |
| Find all providers in zip 31774 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467094649 | South Central Primary Care Center, Inc | Clinic/Center | 149 Chieftain Cir, Ocilla, GA 31774-2231 | 2019-10-09 |
| 1356709646 | South Central Primary Care Center, Inc | Clinic/Center | 607c N Irwin Ave, Ocilla, GA 31774-5009 | 2016-02-02 |
| 1538390729 | South Central Primary Care Center | Clinic/Center | 610 N Irwin Ave, Ocilla, GA 31774-0749 | 2009-08-05 |
| 1558447896 | South Central Primary Care Center, Inc | Clinic/Center | 602 N Irwin Ave Ste B, Ocilla, GA 31774-5040 | 2006-10-30 |
| 1376624569 | South Central Primary Care Center | Clinic/Center | 357 Cargile Rd, Ocilla, GA 31774 | 2006-10-17 |
| 1568963858 | South Central Primary Care Center, Inc | Clinic/Center | 361 Cargile Rd, Ocilla, GA 31774-3606 | 2018-02-22 |
| 1891978854 | South Central Primary Care Center, Inc. | Clinic/Center | 204 E 4th St, Ocilla, GA 31774-1539 | 2007-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
| 1366066243 | Health Education Assessment and Leadership Inc | Clinic/Center | 225 Griffin St Nw, Atlanta, GA 30314-3917 | 2020-06-05 |
| 1851924377 | Valley Healthcare System | Clinic/Center | 1458 Benning Dr, Columbus, GA 31903-2200 | 2020-02-13 |
| 1952941528 | Curtis V. Cooper Primary Health Care, Inc | Clinic/Center | 400 E Broad St, Savannah, GA 31401-5104 | 2020-01-13 |
| 1023658523 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1407 Cobb Parkway Nw, Marietta, GA 30060-6546 | 2020-01-13 |
| 1467092221 | Careconnect Health, Inc. | Clinic/Center | 130 N Lee St, Forsyth, GA 31029-2122 | 2020-01-09 |
| 1417597238 | The Family Health Centers of Georgia, Inc | Clinic/Center | 19 John Maddox Dr Nw Ste B, Rome, GA 30165-1477 | 2020-01-09 |
| 1649810714 | Careconnect Health, Inc. | Clinic/Center | 254 Wright Avenue, Roberta, GA 31078 | 2020-01-07 |
| 1437798725 | Careconnect Health, Inc. | Clinic/Center | 414 S Frontage Rd Lot 53, Forsyth, GA 31029-3025 | 2020-01-03 |
| 1285277608 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1976 Flat Shoals Rd Se Ste B, Atlanta, GA 30316-2857 | 2019-10-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.