Provider Demographics
NPI:1831598135
Name:CAMDEN COUNTY COMMISSIONER OF
Entity type:Organization
Organization Name:CAMDEN COUNTY COMMISSIONER OF
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:POPA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:912-729-8942
Mailing Address - Street 1:701 CHARLES GILMAN JR AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-5661
Mailing Address - Country:US
Mailing Address - Phone:912-729-8942
Mailing Address - Fax:912-729-1059
Practice Address - Street 1:701 CHARLES GILMAN JR AVE
Practice Address - Street 2:SUITE B
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-5661
Practice Address - Country:US
Practice Address - Phone:912-729-8942
Practice Address - Fax:912-729-1059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center