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NPI Code Detail

MEDICARE: MEDLINK GEORGIA INC

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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578942363
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 17 WHITE ST
Second Line :
City : CLEVELAND
State : GA
Zip : 30528-1140
Country : US
Telephone Number : 706-969-7510
Fax Number : 706-348-7791
Authorized Official
Title or Position : CEO
Name : DAVID WARD
Credential :
Telephone Number : 706-788-3234
Provider Enumeration Date : 05/26/2015
Last Update Date : 02/11/2025

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