PRIMARY HEALTH CARE CENTER OF DADE, INC. (NPI# 1891395620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891395620 |
| Entity Type | Organization |
| Organization Name | PRIMARY HEALTH CARE CENTER OF DADE, INC. |
| Practice Address |
8a Probasco Street Unit 214 Lafayette GA 30728 |
| Mailing Address |
13570 N Main St Trenton GA 30752-2012 |
| Practice Telephone | 7067190888 |
| Practice Fax Number | 7066575885 |
| Mailing Telephone | 7069562665 |
| Mailing Fax Number | 7066575885 |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |
| Authorized Official Name | AMY BUFFINGTON (CREDENTIALING DIRECTOR) |
| Authorized Official Telephone | 7066204494 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699016527 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 134 Rhea Mcclanahan Dr, Tunnel Hill, GA 30755-7328 | 2013-03-01 |
| 1356715452 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 87 S Burnt Mill Rd, La Fayette, GA 30728-4263 | 2015-11-30 |
| 1235505678 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 87 S Burnt Mill Rd, La Fayette, GA 30728-4263 | 2015-08-20 |
| 1457770612 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 11638 Highway 27, Suite 8, Summerville, GA 30747-8514 | 2014-04-15 |
| 1952723298 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 118 E Girard Ave, Cedartown, GA 30125-2778 | 2014-01-06 |
| 1255512182 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 205 Jenkins Rd, Rossville, GA 30741 | 2007-11-20 |
| 1437102449 | Primary Health Care Center of Dade, Inc. | Dentist | 13570 N Main St, Trenton, GA 30752-2012 | 2006-05-19 |
| Street Address |
8A PROBASCO STREET UNIT 214 |
| City | LAFAYETTE |
| State | GA |
| Zip Code | 30728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891358750 | K -va -t Food Stores Inc | Durable Medical Equipment & Medical Supplies | 311 North Main Street, Lafayette, GA 30728 | 2019-04-17 |
| 1023505914 | Heather Staton | Pharmacist | 324 W. Patton Street, Lafayette, GA 30728 | 2018-04-17 |
| 1023484805 | Tyler Kellum Levie | Dentist | 201 E. Villanow Street, Lafayette, GA 30728 | 2015-08-17 |
| 1083987481 | Krishawna Elaine Montgomery | Counselor | 501 Mize Street Lookout Mountain Community Services, Lafayette, GA 30728 | 2012-02-15 |
| 1346518198 | William Randall Smith | Behavioral Analyst | 902 Daugherty Street, Lafayette, GA 30728 | 2011-12-08 |
| 1821321506 | John H Rockwell | Contractor | 143 Golden Oaks Dr, La Fayette, GA 30728 | 2009-09-11 |
| 1619113057 | Lookout Mountain Community Services | Community/Behavioral Health | 43 Shady Court, Lafayette, GA 30728 | 2009-01-06 |
| 1326212705 | Lookout Mountain Community Services | Community/Behavioral Health | 1218 Chattanooga St., Lafayette, GA 30728 | 2008-04-17 |
| 1649444084 | Lookout Mountain Community Services | Community/Behavioral Health | 29 Mae Tucker Rd., Lafayette, GA 30728 | 2008-04-16 |
| 1730353178 | Lookout Mountain Community Service | Community/Behavioral Health | 322 New Hope Road, Lafayette, GA 30728 | 2008-04-16 |
| Find all providers in zip 30728 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1356530372 | Central Alabama Comprehensive Health, Inc. | Clinic/Center | 404b 9th Ave S.w., Lafayette, AL 36862 | 2007-10-16 |
| 1609120682 | Southwest Louisiana Primary Health Care Center Inc | Clinic/Center | 1800 Louisiana Ave, Lafayette, LA 70501-3702 | 2012-10-30 |
| 1568731602 | Iberia Comprehensve Community Health Center,inc. | Clinic/Center | 1004 Surrey St, Lafayette, LA 70501-6143 | 2011-12-19 |
| 1316244338 | Iberia Comprehensive Community Health Center, Inc | Clinic/Center | 1002 12th St, Lafayette, LA 70501-6224 | 2011-02-28 |
| 1326214735 | Tippecanoe Community Health Clinic | Clinic/Center | 1716 Hartford St, Lafayette, IN 47904-2173 | 2008-05-06 |
| 1376725952 | Swla Center for Health Services | Clinic/Center | 500 Patterson Street, Lafayette, LA 70501 | 2007-12-05 |
| 1386660900 | Riggs Community Health Center Inc | Clinic/Center | 1716 Hartford St, Lafayette, IN 47904-2173 | 2006-07-15 |
| 1831186915 | Clinica Campesina Family Health Services | Clinic/Center | 1735 S Public Rd Ste 100, Lafayette, CO 80026-7093 | 2005-10-04 |
| Find all providers in LAFAYETTE | ||||
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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.