Provider Demographics
NPI:1417906348
Name:BOWDENMTZION PRIMARY HEALTH CARE CENTER INC
Entity Type:Organization
Organization Name:BOWDENMTZION PRIMARY HEALTH CARE CENTER INC
Other - Org Name:FRANKLIN 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 1:1236 FRANKLIN PKWY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:GA
Mailing Address - Zip Code:30217-7508
Mailing Address - Country:US
Mailing Address - Phone:706-675-8669
Mailing Address - Fax:706-675-3303
Practice Address - Street 1:1236 FRANKLIN PKWY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:GA
Practice Address - Zip Code:30217-7508
Practice Address - Country:US
Practice Address - Phone:706-675-8669
Practice Address - Fax:706-675-3303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000573262AMedicaid
GA000213749BMedicaid
113851Medicare Oscar/Certification