PAVO PRIMARY CARE CLINIC – NPI #1932296811
Clinic/Center

PAVO PRIMARY CARE CLINIC is an AHC clinic located in PAVO, GA. NPPES has assigned the NPI number 1932296811 to PAVO PRIMARY CARE CLINIC on October 10, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PAVO PRIMARY CARE CLINIC” is a dba name, the actual legal business name for this organization is JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.. The primary taxonomy selected by this provider is 261QR1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Rural Health

The NPI profile was previously updated about 18 years ago on May 07, 2008. 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 PAVO PRIMARY CARE CLINIC below.

NPI Profile for
JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.

NPI Number
1932296811
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.
Doing Business As (dba): PAVO PRIMARY CARE CLINIC
Primary location
1103 NORTH MAIN STREET
PAVO, GA 31778
Phone: (229) 859-2622 Fax: (229) 859-2885
Mailing address
920 CAIRO RD
THOMASVILLE, GA 31792-4255
Phone: (229) 228-8800 Fax: (229) 228-8892
Organization Subpart
No
Authorized Official
CHARLES HIGHTOWER
CFO
Phone: (229) 228-2853
Updated
Identifiers

Identifiers for PAVO PRIMARY CARE CLINIC

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.

DescriptionIssuerStateIdentifier
MEDICAIDGA000000063H
Taxonomy Code(s)

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
261QR1300X
- Clinic/Center / Rural Health (Primary)		 GA 136-91

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.