1285803700 NPI number — MURRAY MEDICAL CENTER, INC.

Table of content: (NPI 1285803700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285803700 NPI number — MURRAY MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MURRAY MEDICAL CENTER, 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:
1285803700
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
707 OLD DALTON ELLIJAY RD
Provider Second Line Business Mailing Address:
P.O. BOX 1406
Provider Business Mailing Address City Name:
CHATSWORTH
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30705-2029
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-695-4564
Provider Business Mailing Address Fax Number:
706-517-2077

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
104 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHATSWORTH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30705-2058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-695-4564
Provider Business Practice Location Address Fax Number:
706-517-3718
Provider Enumeration Date:
02/28/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
DANNY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
706-695-4564

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0105125 , 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)

  • Identifier: 000001383B , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com