Provider Demographics
NPI:1093233223
Name:HOSPITAL AUTHORITY OF THE CITY OF BAINBRIDGE AND DECATUR COUNTY GEORGI
Entity Type:Organization
Organization Name:HOSPITAL AUTHORITY OF THE CITY OF BAINBRIDGE AND DECATUR COUNTY GEORGI
Other - Org Name:J SYDNEY COCHRAN, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIRCLOTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-246-8211
Mailing Address - Street 1:1500 E SHOTWELL ST
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-4256
Mailing Address - Country:US
Mailing Address - Phone:229-243-1700
Mailing Address - Fax:229-246-9322
Practice Address - Street 1:1504 E EVANS ST
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-4364
Practice Address - Country:US
Practice Address - Phone:229-246-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty