Provider Demographics
NPI:1104828623
Name:THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY
Other - Org Name:APPLING HEALTHCARE SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-367-9841
Mailing Address - Street 1:PO BOX 2070
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31515-2070
Mailing Address - Country:US
Mailing Address - Phone:912-367-9841
Mailing Address - Fax:912-367-1272
Practice Address - Street 1:163 E TOLLISON ST
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-0120
Practice Address - Country:US
Practice Address - Phone:912-367-9841
Practice Address - Fax:912-367-1272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA273R00000X273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00000052AMedicaid
GA11S071Medicare ID - Type Unspecified