Provider Demographics
NPI:1043514417
Name:TIFT REGIONAL HEALTH SYSTEM, INC.
Entity Type:Organization
Organization Name:TIFT REGIONAL HEALTH SYSTEM, INC.
Other - Org Name:SOUTHWELL MEDICAL SYLVIA BARR CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-353-6104
Mailing Address - Street 1:260 MJ TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:ADEL
Mailing Address - State:GA
Mailing Address - Zip Code:31620-3485
Mailing Address - Country:US
Mailing Address - Phone:229-896-8000
Mailing Address - Fax:229-896-8001
Practice Address - Street 1:260 MJ TAYLOR RD
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:GA
Practice Address - Zip Code:31620-3485
Practice Address - Country:US
Practice Address - Phone:229-896-8000
Practice Address - Fax:229-896-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit