Provider Demographics
NPI:1093894099
Name:HOSPITAL AUTHORITY OF COLUMBUS, GA
Entity Type:Organization
Organization Name:HOSPITAL AUTHORITY OF COLUMBUS, GA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIBOZEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-225-1630
Mailing Address - Street 1:7150 MANOR ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907
Mailing Address - Country:US
Mailing Address - Phone:706-561-3218
Mailing Address - Fax:706-561-6236
Practice Address - Street 1:7150 MANOR ROARD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907
Practice Address - Country:US
Practice Address - Phone:706-561-3218
Practice Address - Fax:706-561-6236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11061245314000000X
GA1106385332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000142117COtherDMPEPOS
GA0254290002OtherSUPPLIER NUMBER
GA0254290002OtherSUPPLIER NUMBER
GA000142117COtherDMPEPOS