| Georgia Department Of Human Resources | |
|
16 E 12th St Sw Rome GA 30161-4720 | |
| (706) 802-5343 | |
| (706) 802-5681 |
| Full Name | Georgia Department Of Human Resources |
|---|---|
| Speciality | Clinic/center - Public Health, State Or Local |
| Location | 16 E 12th St Sw, Rome, Georgia |
| Authorized Official Name and Position | Christopher Wade Sellers (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7062956704 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Department Of Human Resources 1309 Redmond Rd Nw Rome GA 30165-1307 Ph: (706) 802-5343 | Georgia Department Of Human Resources 16 E 12th St Sw Rome GA 30161-4720 Ph: (706) 802-5343 |
| NPI Number | 1033250972 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 07/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033250972 | NPI | - | NPPES |
| 000926879E | Medicaid | GA | |
| 000926879I | Medicaid | GA | |
| 000926879B | Medicaid | GA | |
| 000926879H | Medicaid | GA | |
| 000926879 | Medicaid | GA | |
| 000926879A | Medicaid | GA | |
| 000926879F | Medicaid | GA | |
| 000926879G | Medicaid | GA | |
| 0009288679B | Medicaid | GA | |
| 000926879D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | 025271 (Georgia) | Primary |
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