Organization Name: | PHOEBE WORTH MEDICAL CENTER, INC |
NPI Number: | 1144205014 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STACEY FLYNT (BUSINESS OFFICE MANAGER) |
Mailing Address: | 354 E Washington Ave Ashburn |
State: | GA US |
Postal Code: | 317145222 |
Phone Number: | 2295673361 |
Fax Number: | |
NPI Enumeration Date: | 12/13/2005 |
NPI Last Update Date: | 11/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |