Provider Demographics
NPI:1336839729
Name:HEALTH SERVICES OF CENTRAL GEORGIA, INC
Entity Type:Organization
Organization Name:HEALTH SERVICES OF CENTRAL GEORGIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHREWSBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-633-1052
Mailing Address - Street 1:1005 STATE UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:FORT VALLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31030-4313
Mailing Address - Country:US
Mailing Address - Phone:478-825-6278
Mailing Address - Fax:
Practice Address - Street 1:1005 STATE UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:FORT VALLEY
Practice Address - State:GA
Practice Address - Zip Code:31030-4313
Practice Address - Country:US
Practice Address - Phone:478-825-6278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH SERVICES OF CENTRAL GEORGIA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center