Provider Demographics
NPI:1629279666
Name:HEALTH FIRST, LLC
Entity Type:Organization
Organization Name:HEALTH FIRST, LLC
Other - Org Name:MOUNTAIN VALLEY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:INDA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-746-6571
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:DILLARD
Mailing Address - State:GA
Mailing Address - Zip Code:30537-0444
Mailing Address - Country:US
Mailing Address - Phone:706-746-6571
Mailing Address - Fax:706-746-5643
Practice Address - Street 1:92 BETTYS CREEK RD
Practice Address - Street 2:
Practice Address - City:DILLARD
Practice Address - State:GA
Practice Address - Zip Code:30537-2257
Practice Address - Country:US
Practice Address - Phone:706-746-6571
Practice Address - Fax:706-746-5643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA25380261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000649822AMedicaid
GA000649822AMedicaid
GAD30442Medicare UPIN