PHOEBE PRIMARY CARE OF CAMILLA (NPI# 1700310059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700310059 |
| Entity Type | Organization |
| Organization Name | PHOEBE PRIMARY CARE OF CAMILLA |
| Other Organization Name | CAMILLA FAMILY CARE |
| Practice Address |
725 Us Highway 19 S Camilla GA 31730 |
| Mailing Address |
500 W 3rd Ave Ste 101 Albany GA 31701-1900 |
| Practice Telephone | 2293365208 |
| Practice Fax Number | 2293368260 |
| Mailing Telephone | 2293125802 |
| Mailing Fax Number | 2293125885 |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2017-04-13 |
| Authorized Official Name | ROBIN BROWN (CFO) |
| Authorized Official Telephone | 2295659403 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Camilla Family Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114450665 | Phoebe Primary Care of Camilla | Clinic/Center | 48 Us Highway 19 S, Camilla, GA 31730-1960 | 2017-04-11 |
| Street Address |
725 US HIGHWAY 19 S |
| City | CAMILLA |
| State | GA |
| Zip Code | 31730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134661028 | Montreal Biggins Sr. | Counselor | 198 South Mcarthur Drive, Camilla, GA 31730 | 2016-11-09 |
| 1447639307 | Ledora Inman | Counselor | 198 S. Mac Arthur Drive, Camila, GA 31730 | 2015-05-26 |
| 1336533652 | Southern Therapeutic Massage Studio LLC | Massage Therapist | 88 W. Broad St, Camilla, GA 31730 | 2015-03-25 |
| 1013306604 | Jamekah Brooks | Counselor | 198 S Macarthur Drive, Camilla, GA 31730 | 2015-01-20 |
| 1063811651 | Develle Miller | Counselor | 198 S. Macarthur, Camilla, GA 31730 | 2014-08-19 |
| 1679980247 | Amanda Bryant | Counselor | 198 S. Macarthur Dr., Camilla, GA 31730 | 2014-07-16 |
| 1578993945 | Ted Hall | Counselor | 218 S. Mcarthur Drive, Camilla, GA 31730 | 2013-11-20 |
| 1700216280 | Michael D Fowler I | Case Management | 198 S. Macarthur Drive, Camilla, GA 31730 | 2013-11-19 |
| 1750644753 | Sally Niazi | Pharmacist | 266 E Broad Street, Camilla, GA 31730 | 2012-06-25 |
| 1306123146 | Freds Stores of Tennessee Inc | Pharmacy | 500 Us Hwy 19 South, Camilla, GA 31730 | 2011-11-08 |
| Find all providers in zip 31730 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740312099 | John D. Archbold Memorial Hospital, Inc. | Clinic/Center | 259 Us Highway 19 N, Camilla, GA 31730-1410 | 2007-03-12 |
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| 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.