Provider Demographics
NPI:1033184437
Name:EFFINGHAM HOSPITAL, INC.
Entity Type:Organization
Organization Name:EFFINGHAM HOSPITAL, INC.
Other - Org Name:EFFINGHAM CARE AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WITT
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MBA, LNHA, RN
Authorized Official - Phone:912-754-0160
Mailing Address - Street 1:459 HIGHTWAY 119 SOUTH
Mailing Address - Street 2:ATTN: ALIA ALLEN/MEDICAL STAFF OFFICE
Mailing Address - City:SPRINGFIELD
Mailing Address - State:GA
Mailing Address - Zip Code:31329
Mailing Address - Country:US
Mailing Address - Phone:912-754-0175
Mailing Address - Fax:912-754-6395
Practice Address - Street 1:459 HWY 119 S
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:GA
Practice Address - Zip Code:31329-3021
Practice Address - Country:US
Practice Address - Phone:912-754-0200
Practice Address - Fax:912-754-1250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-20
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-051-315314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000140907AMedicaid
GA000140907AMedicaid