Provider Demographics
NPI:1033982962
Name:HOSPITAL AUTHORITY OF IRWIN COUNTY
Entity Type:Organization
Organization Name:HOSPITAL AUTHORITY OF IRWIN COUNTY
Other - Org Name:IRWIN COUNTY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CNO/COO
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-468-3831
Mailing Address - Street 1:710 N IRWIN AVE
Mailing Address - Street 2:
Mailing Address - City:OCILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31774-5098
Mailing Address - Country:US
Mailing Address - Phone:229-468-3854
Mailing Address - Fax:
Practice Address - Street 1:710 N IRWIN AVE
Practice Address - Street 2:
Practice Address - City:OCILLA
Practice Address - State:GA
Practice Address - Zip Code:31774-5098
Practice Address - Country:US
Practice Address - Phone:229-468-3854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy