Provider Demographics
NPI:1164509931
Name:HOSPITAL AUTHORITY OF COLUMBUS GA
Entity Type:Organization
Organization Name:HOSPITAL AUTHORITY OF COLUMBUS GA
Other - Org Name:RIDGECREST REHAB & SKILLED NURSING CENTER
Other - Org Type:Doing Business As
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 1:8329 STEVENS LANE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909
Mailing Address - Country:US
Mailing Address - Phone:706-330-5650
Mailing Address - Fax:706-323-9355
Practice Address - Street 1:8329 STEVENS LANE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909
Practice Address - Country:US
Practice Address - Phone:706-330-5650
Practice Address - Fax:706-323-9355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA232200314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000142117COtherDMEPOS
GA000141886AMedicaid
GA000142117COtherDMEPOS
GA115478Medicare ID - Type UnspecifiedMEDICARE