Provider Demographics
NPI:1467909374
Name:MEDLINK GEORGIA INC
Entity Type:Organization
Organization Name:MEDLINK GEORGIA INC
Other - Org Name:MEDLINK COMMERCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-788-3234
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:GA
Mailing Address - Zip Code:30628-0459
Mailing Address - Country:US
Mailing Address - Phone:706-788-3234
Mailing Address - Fax:706-788-2936
Practice Address - Street 1:306 COURTHOUSE SQ
Practice Address - Street 2:
Practice Address - City:DANIELSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30633-7059
Practice Address - Country:US
Practice Address - Phone:706-423-9291
Practice Address - Fax:706-760-5335
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDLINK GEORGIA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-08
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)