NPI | 1467223818 |
---|---|
Doing Business As | SOUTH CENTRAL PRIMARY CARE- ASHLEY STREET |
Entity Type | Organization |
Authorized Contact | ROBERT BONDS TUCKER CEO 229-468-9166 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2024-01-15 |
Last Update Date | 2024-10-22 |