1548644586 NPI number — THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY

Table of content: (NPI 1548644586)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548644586 NPI number — THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY
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:
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:
1548644586
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 37
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DEMOREST
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30535-0037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-754-3113
Provider Business Mailing Address Fax Number:
706-839-4001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
541 HISTORIC HWY 441 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEMOREST
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-754-3113
Provider Business Practice Location Address Fax Number:
706-839-4001
Provider Enumeration Date:
07/18/2015

Additional Information

Authorized Official

Authorized Official Last Name:
DUNCAN
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
H
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
706-839-4000

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  PHWH003733 , 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)





Copyright © 2007-2024 www.npivalidator.com