1598990376 NPI number — PHOEBE SUMTER MEDICAL CENTER, 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 1598990376 NPI number — PHOEBE SUMTER MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHOEBE SUMTER 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:
PHOEBE SUMTER MEDICAL CENTER
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:
1598990376
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
126 HWY 280 W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMERICUS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31719-8645
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
229-312-6761
Provider Business Mailing Address Fax Number:
229-312-6705

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
126 HWY 280 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMERICUS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31719-8645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
229-312-6761
Provider Business Practice Location Address Fax Number:
229-312-6705
Provider Enumeration Date:
05/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
LOUDERMILK
Authorized Official First Name:
KERRY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
SR. VP / CFO
Authorized Official Telephone Number:
229-312-4068

Provider Taxonomy Codes

  • Taxonomy code: 273Y00000X , 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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