SOUTH CENTRAL PRIMARY CARE CENTER, INC – NPI #1063840296
Clinic/Center
SOUTH CENTRAL PRIMARY CARE CENTER, INC is an AHC clinic located in DOUGLAS, GA. NPPES has assigned the NPI number 1063840296 to SOUTH CENTRAL PRIMARY CARE CENTER, INC on October 25, 2013. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)
The NPI profile was last updated on Apr 03, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTH CENTRAL PRIMARY CARE CENTER, INC below.
NPI Profile for
SOUTH CENTRAL PRIMARY CARE CENTER, INC
(more than 12 years ago)
All associated names:
KIDS HEALTH
SOUTH CENTRAL PRIMARY CARE
STE B
DOUGLAS, GA 31533 Phone: (912) 384-2474 Fax: (912) 384-4995
P O BOX 749
OCILLA, GA 31774-1539 Phone: (229) 468-9166 Fax: (229) 468-9188
CEO
Phone: (229) 468-9166
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
Identifiers for SOUTH CENTRAL PRIMARY CARE CENTER, INC
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| medicaid | GA | 003140047A |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 261QF0400X - Clinic/Center / Federally Qualified Health Center (FQHC) (Primary) |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.