Provider Demographics
NPI:1043441587
Name:THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA
Entity Type:Organization
Organization Name:THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA
Other - Org Name:MONROE PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:FIRSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-994-8786
Mailing Address - Street 1:235 MEDICAL CT
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-1662
Mailing Address - Country:US
Mailing Address - Phone:478-994-8786
Mailing Address - Fax:478-994-8787
Practice Address - Street 1:235 MEDICAL CT
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-1662
Practice Address - Country:US
Practice Address - Phone:478-994-8786
Practice Address - Fax:478-994-8787
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-31
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QP2300X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care