Provider Demographics
NPI:1417428772
Name:BOWDON-MT ZION PRIMARY HEALTH CENTER INC.
Entity Type:Organization
Organization Name:BOWDON-MT ZION PRIMARY HEALTH CENTER INC.
Other - Org Name:MTZION PRIMARY HEALTHCARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-675-8669
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:MOUNT ZION
Mailing Address - State:GA
Mailing Address - Zip Code:30150-0658
Mailing Address - Country:US
Mailing Address - Phone:770-836-0103
Mailing Address - Fax:770-834-8828
Practice Address - Street 1:4248 MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-7602
Practice Address - Country:US
Practice Address - Phone:770-836-0103
Practice Address - Fax:770-834-8828
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOWDON-MT ZION PRIMARY HEALTH CENTER INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-16
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty