| Organization Name: | CHARLTON MEMORIAL HOSPITAL |
| NPI Number: | 1760548002 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FATIMA MCCASLAND (CLINIC DIRECTOR) |
| Mailing Address: | 2383 Third St Folkston |
| State: | GA US |
| Postal Code: | 315378917 |
| Phone Number: | 9124962697 |
| Fax Number: | 9124961139 |
| NPI Enumeration Date: | 12/29/2006 |
| NPI Last Update Date: | 07/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |