GEORGIA VOLUNTEER HEALTH CARE PROGRAM


Address: 6744 Brookfield Way, Douglasville, GA 30134-1461
Phone: 7708375656

GEORGIA VOLUNTEER HEALTH CARE PROGRAM (NPI# 1710437579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1710437579
Entity Type Organization
Organization Name GEORGIA VOLUNTEER HEALTH CARE PROGRAM
Practice Address 6744 Brookfield Way
Douglasville
GA 30134-1461
Practice Telephone 7708375656
Enumeration Date 2016-10-05
Last Update Date 2016-10-05
Authorized Official Name MS. PRINCESS B. CLARK (FNP)
Authorized Official Telephone 7708375656
Authorized Official Credential FNP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center RN128145 GA Ambulatory Health Care Facilities

Office Location

Street Address 6744 BROOKFIELD WAY
City DOUGLASVILLE
State GA
Zip Code 30134-1461

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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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1417140831 Georgia One Medical Services Clinic/Center 7193 Douglas Blvd, Suite 202, Douglasville, GA 30135-1540 2007-08-20
1861560286 Rediclinic LLC Clinic/Center 9465 Highway 5, Douglasville, GA 30135 2006-12-01

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Competitor

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City DOUGLASVILLE
Zip Code 30134

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Dataset Information

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.

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