Provider Demographics
NPI:1285663856
Name:ROCKDALE MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:ROCKDALE MEDICAL CENTER INC.
Other - Org Name:ROCKDALE HOSPITAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-918-3101
Mailing Address - Street 1:1412 MILSTEAD AVE NE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3877
Mailing Address - Country:US
Mailing Address - Phone:770-918-3000
Mailing Address - Fax:
Practice Address - Street 1:1412 MILSTEAD AVE NE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3877
Practice Address - Country:US
Practice Address - Phone:770-918-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00001603AMedicaid
GA110091Medicare Oscar/Certification