Organization Name: | JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. |
NPI Number: | 1356372304 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLES D. HIGHTOWER (CFO) |
Mailing Address: | 101 E Davis St Quitman |
State: | GA US |
Postal Code: | 316431407 |
Phone Number: | 2292636340 |
Fax Number: | 2292636330 |
NPI Enumeration Date: | 07/06/2006 |
NPI Last Update Date: | 05/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | ESRD004044 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |