| Colquitt Family Care, Inc. | |
|
2801 S Main St Moultrie GA 31768-6908 | |
| (229) 891-2170 | |
| Not Available |
| Full Name | Colquitt Family Care, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 2801 S Main St, Moultrie, Georgia |
| Authorized Official Name and Position | Roland Manoutcheher Brown (OWNER) |
| Authorized Official Contact | 2298912170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colquitt Family Care, Inc. 2801 S Main St Moultrie GA 31768-6908 Ph: (229) 891-2170 | Colquitt Family Care, Inc. 2801 S Main St Moultrie GA 31768-6908 Ph: (229) 891-2170 |
| NPI Number | 1215088174 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215088174 | NPI | - | NPPES |
| 85001900G | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 043008 (Georgia) | Primary |
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