| Vidalia Family Care Llc | |
|
1702 Meadows Ln Vidalia GA 30474-7219 | |
| (912) 805-2198 | |
| (912) 805-2997 |
| Full Name | Vidalia Family Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1702 Meadows Ln, Vidalia, Georgia |
| Authorized Official Name and Position | John Burton Derrick (CEO) |
| Authorized Official Contact | 9122933308 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vidalia Family Care Llc Po Box 645 Vidalia GA 30475-0645 Ph: (912) 293-3308 | Vidalia Family Care Llc 1702 Meadows Ln Vidalia GA 30474-7219 Ph: (912) 805-2198 |
| NPI Number | 1114733250 |
|---|---|
| Provider Enumeration Date | 12/04/2024 |
| Last Update Date | 12/04/2024 |
| Medicare PECOS PAC ID | 0749701506 |
|---|---|
| Medicare Enrollment ID | O20250310000850 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114733250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Sharifa Abou-mediene |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750571956 PECOS PAC ID: 2264795376 Enrollment ID: I20180423002857 |
Misty D. Poole, Md, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 210 Mose Coleman Dr, Vidalia, GA 30474 Phone: 912-537-2200 Fax: 912-537-2260 | |
Wheeler County Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Maple Dr, Vidalia, GA 30474 Phone: 912-537-0616 Fax: 912-537-0617 | |
Southeast Regional Primary Care Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 621 E 1st St Ste B, Vidalia, GA 30474 Phone: 912-535-5120 | |
Tattnall Hospital Company, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1811 Edwina Drive, Vidalia, GA 30474 Phone: 912-537-9779 Fax: 912-537-2124 | |
Wiggins Family Practice Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 Arlington Dr, Vidalia, GA 30474 Phone: 912-537-2530 Fax: 912-537-2540 | |
Vidalia Neurology Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1707 Meadows Lane, Suite A, Vidalia, GA 30474 Phone: 912-537-9779 |