Provider Demographics
NPI:1467738559
Name:DARIEN PRIMARY CARE INC
Entity Type:Organization
Organization Name:DARIEN PRIMARY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:CNM ARNP
Authorized Official - Phone:912-674-3980
Mailing Address - Street 1:1135 NORTH WAY
Mailing Address - Street 2:E BOX 2690
Mailing Address - City:DARIEN
Mailing Address - State:GA
Mailing Address - Zip Code:31305-2690
Mailing Address - Country:US
Mailing Address - Phone:912-437-3025
Mailing Address - Fax:912-437-7774
Practice Address - Street 1:1135 NORTH WAY
Practice Address - Street 2:STE E
Practice Address - City:DARIEN
Practice Address - State:GA
Practice Address - Zip Code:31305
Practice Address - Country:US
Practice Address - Phone:912-437-2442
Practice Address - Fax:912-437-7774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN217510363LF0000X
GARN 165440367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003124500AMedicaid
GA003124500AMedicaid