Healthcare Provider Details

I. General information

NPI: 1508720822
Provider Name (Legal Business Name): QCPI-VILLAGEMD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 VENTURE CT
MONTICELLO GA
31064-7788
US

IV. Provider business mailing address

545 VENTURE CT
MONTICELLO GA
31064-7788
US

V. Phone/Fax

Practice location:
  • Phone: 706-468-7002
  • Fax:
Mailing address:
  • Phone: 706-468-7002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHERI SZOKOLAY
Title or Position: DIRECTOR REV CYCLE
Credential:
Phone: 770-822-6853