| Primary Health Care Center Of Dade, Inc. | |
|
2009 Old Lafayette Rd Fort Oglethorpe GA 30742-3510 | |
| (706) 866-5520 | |
| (706) 866-5502 |
| Full Name | Primary Health Care Center Of Dade, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2009 Old Lafayette Rd, Fort Oglethorpe, Georgia |
| Authorized Official Name and Position | Amy L Buffington (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 7069562665 |
| 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. 2009 Old Lafayette Rd Fort Oglethorpe GA 30742-3510 Ph: (706) 866-5520 |
| NPI Number | 1255512182 |
|---|---|
| Provider Enumeration Date | 11/20/2007 |
| Last Update Date | 09/22/2022 |
| Medicare PECOS PAC ID | 0547272650 |
|---|---|
| Medicare Enrollment ID | O20060607000231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255512182 | NPI | - | NPPES |
| 000211956C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Lemuel M Arnold |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942302070 PECOS PAC ID: 1456314178 Enrollment ID: I20050302000967 |
| Provider Name | William L Horton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144292798 PECOS PAC ID: 8820150535 Enrollment ID: I20100803001207 |
| Provider Name | Kenneth W Patric |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366480014 PECOS PAC ID: 8123124823 Enrollment ID: I20130628000015 |
| Provider Name | Courtney Cummings |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275784621 PECOS PAC ID: 5991021735 Enrollment ID: I20191021001053 |
| Provider Name | Haley Nicole Catanzarito |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447600044 PECOS PAC ID: 8921435769 Enrollment ID: I20200217004164 |
| Provider Name | Jazzmine Basham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114451051 PECOS PAC ID: 5294088480 Enrollment ID: I20220112001201 |
| Provider Name | Adrienne N Harrington-merriweather |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639391956 PECOS PAC ID: 6204029465 Enrollment ID: I20220929001104 |
| Provider Name | Danielle C Townsend |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1407210107 PECOS PAC ID: 4981054111 Enrollment ID: I20231229000785 |
| Provider Name | Brittany G Dee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245936673 PECOS PAC ID: 4385189547 Enrollment ID: I20240711002601 |
| Provider Name | Anna Katharine Horne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871152587 PECOS PAC ID: 2769927813 Enrollment ID: I20240712001468 |
| Provider Name | Felix D Cruz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518593151 PECOS PAC ID: 0840739611 Enrollment ID: I20240823002720 |
Utm Of Georgia Physicians Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 Battlefield Pkwy, Fort Oglethorpe, GA 30742 Phone: 615-988-2009 | |
Vitalis Behavioral Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1638 Battlefield Pkwy, Fort Oglethorpe, GA 30742 Phone: 706-841-0500 Fax: 706-841-0502 | |
Rose Medical, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Gross Crescent Cir, Suite 201, Fort Oglethorpe, GA 30742 Phone: 513-550-1305 | |
Hmc Physician Billing Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Gross Crescent Circle, Fort Oglethorpe, GA 30742 Phone: 706-858-2254 | |
Benchmark Healthcare Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1394 Battlefield Pkwy, Fort Oglethorpe, GA 30742 Phone: 706-858-0252 Fax: 706-858-0323 | |
Primary Health Care Center Of Dade, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Mitchell Rd, Fort Oglethorpe, GA 30742 Phone: 706-866-5520 Fax: 706-657-2958 |