| Coffee Regional Medical Center, Inc | |
|
1301 Peterson Ave S Ste B Douglas GA 31533-2327 | |
| (912) 383-6966 | |
| (912) 383-5667 |
| Full Name | Coffee Regional Medical Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1301 Peterson Ave S, Douglas, Georgia |
| Authorized Official Name and Position | Vicki Lewis (PRESIDENT/CEO) |
| Authorized Official Contact | 9123841900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coffee Regional Medical Center, Inc Po Box 1287 Douglas GA 31534-1287 Ph: (912) 384-1900 | Coffee Regional Medical Center, Inc 1301 Peterson Ave S Ste B Douglas GA 31533-2327 Ph: (912) 383-6966 |
| NPI Number | 1639211956 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 09/23/2022 |
| Medicare PECOS PAC ID | 4587656012 |
|---|---|
| Medicare Enrollment ID | O20100607000843 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639211956 | NPI | - | NPPES |
| 00000448D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Crh Physician Practices, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1305 Ocilla Rd, Douglas, GA 31533 Phone: 912-384-0600 Fax: 912-384-0601 | |
Coffee Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Doctors Dr, Ste 224, Douglas, GA 31533 Phone: 912-384-2353 | |
South Central Primary Care Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 Shirley Ave, Ste B, Douglas, GA 31533 Phone: 912-384-2474 Fax: 912-384-4995 | |
Abigail Miller Family Medicine Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 Shirley Ave, Douglas, GA 31533 Phone: 912-384-7300 | |
Douglas Medical Specialist Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 Doctors Dr Ste 106, Douglas, GA 31533 Phone: 912-384-3338 Fax: 912-383-6365 | |
Crh Physician Practices Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Doctors Dr, Ste 101, Douglas, GA 31533 Phone: 912-389-1558 Fax: 912-389-1558 | |
Douglas Internal Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Madison Ave S, Douglas, GA 31533 Phone: 912-383-7826 Fax: 912-383-7299 |