1043477193 NPI number — LOWER OCONEE COMMUNITY HOSPITAL, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043477193 NPI number — LOWER OCONEE COMMUNITY HOSPITAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOWER OCONEE COMMUNITY 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:
Provider Other Organization Name Type Code:
6
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:
1043477193
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
280 E WILLOW CREEK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MC RAE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31055-5180
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
229-868-4122
Provider Business Mailing Address Fax Number:
229-868-4124

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
280 E WILLOW CREEK LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC RAE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31055-2184
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
229-868-4122
Provider Business Practice Location Address Fax Number:
229-868-4124
Provider Enumeration Date:
05/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
FOWLER
Authorized Official First Name:
LYNAN
Authorized Official Middle Name:
P
Authorized Official Title or Position:
BUSINESS OFFICE MANAGER
Authorized Official Telephone Number:
912-523-5113

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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