MEDICARE: MEDLINK GEORGIA, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1306563515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDLINK GEORGIA, INC

Provider Business Mailing Address
First Line	:	PO BOX 459
Second Line	:
City	:	COLBERT
State	:	GA
Zip	:	30628-0459
Country	:	US
Telephone Number	:	706-788-3234
Fax Number	:

Provider Business Practice Location Address
First Line	:	811 HIGHWAY 441 N STE 102
Second Line	:
City	:	CLAYTON
State	:	GA
Zip	:	30525-4202
Country	:	US
Telephone Number	:	706-521-3113
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DAVE WARD
Credential	:
Telephone Number	:	706-788-3234

Provider Enumeration Date	:	10/27/2022
Last Update Date	:	02/18/2026

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