Provider Demographics
NPI:1326223876
Name:HEALTHCARE OF BERRIEN COUNTY
Entity Type:Organization
Organization Name:HEALTHCARE OF BERRIEN COUNTY
Other - Org Name:THE NEAR CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-543-7314
Mailing Address - Street 1:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31639-0665
Mailing Address - Country:US
Mailing Address - Phone:229-686-7824
Mailing Address - Fax:229-686-9549
Practice Address - Street 1:1223 E MCPHERSON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639-2351
Practice Address - Country:US
Practice Address - Phone:229-686-7824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHCARE OF BERRIEN COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health