Provider Demographics
NPI:1851947113
Name:MIDDLE GEORGIA COMPLETE CARE LLC
Entity Type:Organization
Organization Name:MIDDLE GEORGIA COMPLETE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:NARTEY
Authorized Official - Last Name:NARH-MARTEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-446-3072
Mailing Address - Street 1:1114 GA HIGHWAY 96
Mailing Address - Street 2:STE C-1 #243
Mailing Address - City:KATHLEEN
Mailing Address - State:GA
Mailing Address - Zip Code:31047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:504 OSIGIAN BLVD STE 2
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8014
Practice Address - Country:US
Practice Address - Phone:478-213-7657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service