Provider Demographics
NPI:1235756644
Name:HOSPITAL AUTHORITY OF MILLER COUNTY
Entity Type:Organization
Organization Name:HOSPITAL AUTHORITY OF MILLER COUNTY
Other - Org Name:MILLER HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-758-5954
Mailing Address - Street 1:207 W GEER STREET
Mailing Address - Street 2:
Mailing Address - City:COLQUITT
Mailing Address - State:GA
Mailing Address - Zip Code:39837-3533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:207 W GEER STREET
Practice Address - Street 2:
Practice Address - City:COLQUITT
Practice Address - State:GA
Practice Address - Zip Code:39837-3533
Practice Address - Country:US
Practice Address - Phone:229-758-4212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL AUTHORITY OF MILLER COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-01
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGA117339OtherLICENSE
GA117801OtherMEDICARE NUMBER
GA003264041AMedicaid