Provider Demographics
NPI:1003406463
Name:TMC/HIGGINS GENERAL HOSPITAL
Entity Type:Organization
Organization Name:TMC/HIGGINS GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:S
Authorized Official - Last Name:CREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-812-9745
Mailing Address - Street 1:100 PROFESSIONAL PL STE 305
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3872
Mailing Address - Country:US
Mailing Address - Phone:770-812-8614
Mailing Address - Fax:770-812-8372
Practice Address - Street 1:706 DIXIE ST STE 140
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3859
Practice Address - Country:US
Practice Address - Phone:770-812-8614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TMC HIGGINS GENERAL HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy