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CHC00836-25 SOUTH CENTRAL PRIMARY CARE CENTER, INC. (Terminated)
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Main Details
Name
SOUTH CENTRAL PRIMARY CARE CENTER, INC.
Subdivision Name
SOUTH CENTRAL FAMILY MEDICINE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017774
340B ID
CHC00836-25
Grant Number
H80CS00836
Additional Details
Current Program Status
Terminated
Registration Date
4/9/2024
Participating Start Date
7/1/2024
Participating Approval Date
6/5/2024
Last Recertification Date
Termination Date
Termination Reason
1/1/2025
Other
Contacts
Authorizing Official
South Central Primary Care Center, Inc.
Robert B. Tucker, CEO
(229) 468-9166 Ext: 1
Primary Contact
South Central Primary Care Center, Inc.
Judy Swanson, Nurse Manager
(229) 468-9166
Addresses
Street Address
640 Main St N
Pearson, GA 31642
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
June 2025
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