PRIMARY HEALTH CARE CENTER OF DADE, INC. (NPI# 1356715452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356715452 |
| Entity Type | Organization |
| Organization Name | PRIMARY HEALTH CARE CENTER OF DADE, INC. |
| Practice Address |
87 S Burnt Mill Rd La Fayette GA 30728-4263 |
| Mailing Address |
13570 N Main St Trenton GA 30752-2012 |
| Practice Telephone | 7066204494 |
| Practice Fax Number | 7066572958 |
| Mailing Telephone | 7069562665 |
| Mailing Fax Number | 7066572958 |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2015-11-30 |
| Authorized Official Name | DIANA U ALLEN (CEO) |
| Authorized Official Telephone | 7066204494 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
| 1699016527 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 134 Rhea Mcclanahan Dr, Tunnel Hill, GA 30755-7328 | 2013-03-01 |
| 1235505678 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 87 S Burnt Mill Rd, La Fayette, GA 30728-4263 | 2015-08-20 |
| 1457770612 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 11638 Highway 27, Suite 8, Summerville, GA 30747-8514 | 2014-04-15 |
| 1952723298 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 118 E Girard Ave, Cedartown, GA 30125-2778 | 2014-01-06 |
| 1255512182 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 205 Jenkins Rd, Rossville, GA 30741 | 2007-11-20 |
| 1437102449 | Primary Health Care Center of Dade, Inc. | Dentist | 13570 N Main St, Trenton, GA 30752-2012 | 2006-05-19 |
| Street Address |
87 S BURNT MILL RD |
| City | LA FAYETTE |
| State | GA |
| Zip Code | 30728-4263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265812408 | Melissa Morton Lee | Nurse Practitioner | 87 S Burnt Mill Rd, La Fayette, GA 30728-4263 | 2015-06-03 |
| 1235505678 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 87 S Burnt Mill Rd, La Fayette, GA 30728-4263 | 2015-08-20 |
| 1043694912 | Mathew Owens | Dentist | 87 S Burnt Mill Rd, La Fayette, GA 30728-4263 | 2015-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
| 1891358750 | K -va -t Food Stores Inc | Durable Medical Equipment & Medical Supplies | 311 North Main Street, Lafayette, GA 30728 | 2019-04-17 |
| 1023505914 | Heather Staton | Pharmacist | 324 W. Patton Street, Lafayette, GA 30728 | 2018-04-17 |
| 1023484805 | Tyler Kellum Levie | Dentist | 201 E. Villanow Street, Lafayette, GA 30728 | 2015-08-17 |
| 1083987481 | Krishawna Elaine Montgomery | Counselor | 501 Mize Street Lookout Mountain Community Services, Lafayette, GA 30728 | 2012-02-15 |
| 1346518198 | William Randall Smith | Behavioral Analyst | 902 Daugherty Street, Lafayette, GA 30728 | 2011-12-08 |
| 1821321506 | John H Rockwell | Contractor | 143 Golden Oaks Dr, La Fayette, GA 30728 | 2009-09-11 |
| 1619113057 | Lookout Mountain Community Services | Community/Behavioral Health | 43 Shady Court, Lafayette, GA 30728 | 2009-01-06 |
| 1326212705 | Lookout Mountain Community Services | Community/Behavioral Health | 1218 Chattanooga St., Lafayette, GA 30728 | 2008-04-17 |
| 1649444084 | Lookout Mountain Community Services | Community/Behavioral Health | 29 Mae Tucker Rd., Lafayette, GA 30728 | 2008-04-16 |
| Find all providers in zip 30728 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235505678 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 87 S Burnt Mill Rd, La Fayette, GA 30728-4263 | 2015-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
| 1366066243 | Health Education Assessment and Leadership Inc | Clinic/Center | 225 Griffin St Nw, Atlanta, GA 30314-3917 | 2020-06-05 |
| 1851924377 | Valley Healthcare System | Clinic/Center | 1458 Benning Dr, Columbus, GA 31903-2200 | 2020-02-13 |
| 1952941528 | Curtis V. Cooper Primary Health Care, Inc | Clinic/Center | 400 E Broad St, Savannah, GA 31401-5104 | 2020-01-13 |
| 1023658523 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1407 Cobb Parkway Nw, Marietta, GA 30060-6546 | 2020-01-13 |
| 1467092221 | Careconnect Health, Inc. | Clinic/Center | 130 N Lee St, Forsyth, GA 31029-2122 | 2020-01-09 |
| 1417597238 | The Family Health Centers of Georgia, Inc | Clinic/Center | 19 John Maddox Dr Nw Ste B, Rome, GA 30165-1477 | 2020-01-09 |
| 1649810714 | Careconnect Health, Inc. | Clinic/Center | 254 Wright Avenue, Roberta, GA 31078 | 2020-01-07 |
| 1437798725 | Careconnect Health, Inc. | Clinic/Center | 414 S Frontage Rd Lot 53, Forsyth, GA 31029-3025 | 2020-01-03 |
| 1285277608 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1976 Flat Shoals Rd Se Ste B, Atlanta, GA 30316-2857 | 2019-10-18 |
| Find all providers with the same taxonomy | ||||
| City | LA FAYETTE |
| Zip Code | 30728 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.