Healthcare Provider Details

I. General information

NPI: 1134316219
Provider Name (Legal Business Name): HEALTH FIRST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 BETTYS CREEK RD
DILLARD GA
30537-2257
US

IV. Provider business mailing address

PO BOX 444
DILLARD GA
30537-0444
US

V. Phone/Fax

Practice location:
  • Phone: 706-746-6571
  • Fax: 706-746-5643
Mailing address:
  • Phone: 706-746-6571
  • Fax: 706-746-5643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number025380
License Number StateGA

VIII. Authorized Official

Name: CARLIE SUZANNE PENNINGTON
Title or Position: OFFICE MANAGER
Credential:
Phone: 706-746-6571