MEDICARE: HEALTH SERVICES OF CENTRAL 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1336839729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH SERVICES OF CENTRAL GEORGIA, INC

Provider Business Mailing Address
First Line	:	1005 STATE UNIVERSITY DR
Second Line	:
City	:	FORT VALLEY
State	:	GA
Zip	:	31030-4313
Country	:	US
Telephone Number	:	478-825-6278
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 STATE UNIVERSITY DR
Second Line	:
City	:	FORT VALLEY
State	:	GA
Zip	:	31030-4313
Country	:	US
Telephone Number	:	478-825-6278
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	PHILIP WHEELER
Credential	:
Telephone Number	:	706-509-3012

Provider Enumeration Date	:	05/10/2023
Last Update Date	:	08/27/2025

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