PRIMARY HEALTH CARE CENTER OF DADE INC. NPI 1437102449

NPI Information

NPI: 1437102449
Provider Name: PRIMARY HEALTH CARE CENTER OF DADE, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
13570 N MAIN ST
TRENTON, GA
ZIP 30752
Phone: (706) 956-2665
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PRIMARY HEALTH CARE CENTER OF DADE, INC. is a federally qualified health center (fqhc) clinic center in Trenton, GA. PRIMARY HEALTH CARE CENTER OF DADE, INC. NPI is 1437102449. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

13570 N MAIN ST
TRENTON, GA
ZIP 30752-012
Phone: (706) 956-2665
Fax: (706) 657-5885

The provider's authorized official is Linda S Nixon .
The authorized official title is Chief Financial Officer and has the following contact phone number (706) 657-7575.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 1/21/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice			No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000211956A	MEDICAID	GEORGIA
2	336412	OTHER	GEORGIA	WELLCARE (GA MEDICAID MCO
3	10057286	OTHER	GEORGIA	AMERIGROUP (GA MEDICAID)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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