Provider Demographics
NPI:1033200852
Name:MACON HOSPITAL, INC.
Entity Type:Organization
Organization Name:MACON HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT FINANCIAL SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:HALEY
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-666-2147
Mailing Address - Street 1:204 MEDICAL DR
Mailing Address - Street 2:P O BOX 378
Mailing Address - City:LAFAYETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37083-1719
Mailing Address - Country:US
Mailing Address - Phone:615-666-7927
Mailing Address - Fax:615-666-7052
Practice Address - Street 1:305 W LOCUST ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:TN
Practice Address - Zip Code:37083-1712
Practice Address - Country:US
Practice Address - Phone:615-666-7927
Practice Address - Fax:615-666-7052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000080275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN44-Z305Medicare Oscar/Certification