1164651022 NPI number — EFFINGHAM HOSPITAL, INC.

Table of content: (NPI 1164651022)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164651022 NPI number — EFFINGHAM HOSPITAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EFFINGHAM HOSPITAL, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EFFINGHAM FAMILY MEDICINE AT GUYTON
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164651022
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
459 HIGHWAY 119 SOUTH
Provider Second Line Business Mailing Address:
ATTN.: ALIA ALLEN/MEDICAL STAFF OFFICE
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31329
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-754-0175
Provider Business Mailing Address Fax Number:
912-754-6395

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 HIDDEN CREEK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GUYTON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31312-4590
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-772-8670
Provider Business Practice Location Address Fax Number:
912-754-1037
Provider Enumeration Date:
07/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
BAKER-WITT
Authorized Official First Name:
FRANCINE
Authorized Official Middle Name:
Authorized Official Title or Position:
INTERIM CEO
Authorized Official Telephone Number:
912-754-0142

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com