Provider Demographics
NPI:1235585092
Name:PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR CENTRAL BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-369-5472
Mailing Address - Street 1:PO BOX 161463
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30321-1463
Mailing Address - Country:US
Mailing Address - Phone:706-369-5474
Mailing Address - Fax:706-369-5490
Practice Address - Street 1:1270 PRINCE AVE
Practice Address - Street 2:STE 201
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2762
Practice Address - Country:US
Practice Address - Phone:706-548-2133
Practice Address - Fax:706-548-7153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty