| Primary Health Care Center Of Dade, Inc. | |
|
13570 N Main St Trenton GA 30752-2012 | |
| (706) 956-2665 | |
| (706) 657-5885 |
| Full Name | Primary Health Care Center Of Dade, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 13570 N Main St, Trenton, Georgia |
| Authorized Official Name and Position | Linda S Nixon (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7066577575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Health Care Center Of Dade, Inc. 13570 N Main St Trenton GA 30752-2012 Ph: (706) 657-7575 | Primary Health Care Center Of Dade, Inc. 13570 N Main St Trenton GA 30752-2012 Ph: (706) 956-2665 |
| NPI Number | 1437102449 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 01/21/2019 |
| Medicare PECOS PAC ID | 0547272650 |
|---|---|
| Medicare Enrollment ID | O20100623000972 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437102449 | NPI | - | NPPES |
| 10057286 | Other | GA | AMERIGROUP (GA MEDICAID) |
| 336412 | Other | GA | WELLCARE (GA MEDICAID MCO |
| 000211956A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Trenton Family Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11804 S Main St, Trenton, GA 30752 Phone: 706-906-6965 | |
Red Rock Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10621 Highway 11, Trenton, GA 30752 Phone: 706-657-7561 |