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CH044369G Primary Care Of Southwest Georgia, Inc. (Active)
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Main Details
Name
Primary Care Of Southwest Georgia, Inc.
Subdivision Name
Primary Care of Southwest Georgia - Early County Elementary School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032894
340B ID
CH044369G
Grant Number
H80CS06454
Additional Details
Current Program Status
Active
Registration Date
4/8/2022
Participating Start Date
7/1/2022
Participating Approval Date
4/12/2022
Last Recertification Date
2/21/2025
Contacts
Authorizing Official
Primary Care of Southwest Georgia
EDWIN JAMES, CFO
(229) 723-2660 Ext: 2131
Primary Contact
Primary Care of Southwest Georgia
Melody Parker, Pharmacy Manager
(229) 516-8877
Addresses
Street Address
283 Martin Luther King Jr Blvd
Blakely, GA 39823-3455
Billing Address
Primary Care of Southwest Georgia Inc
360 College St
Blakely, GA 39823
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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