Provider Demographics
NPI:1265494710
Name:HUTCHESON MEDICAL CENTER
Entity Type:Organization
Organization Name:HUTCHESON MEDICAL CENTER
Other - Org Name:DBA PARKSIDE AT HUTCHESON MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-858-2101
Mailing Address - Street 1:110 PARK CITY RD
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30741-3980
Mailing Address - Country:US
Mailing Address - Phone:706-858-2000
Mailing Address - Fax:706-858-2732
Practice Address - Street 1:110 PARK CITY RD
Practice Address - Street 2:
Practice Address - City:ROSSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30741-3980
Practice Address - Country:US
Practice Address - Phone:706-858-2000
Practice Address - Fax:706-858-2732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11462313313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility