Provider Demographics
NPI:1316027352
Name:HOSPITAL AUTHORITY OF CALHOUN COUNTY
Entity Type:Organization
Organization Name:HOSPITAL AUTHORITY OF CALHOUN COUNTY
Other - Org Name:CALHOUN MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOM
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:W
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-725-2147
Mailing Address - Street 1:55 R E JENNINGS AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:39813
Mailing Address - Country:US
Mailing Address - Phone:229-725-4272
Mailing Address - Fax:
Practice Address - Street 1:55 R E JENNINGS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:GA
Practice Address - Zip Code:39813
Practice Address - Country:US
Practice Address - Phone:229-725-4272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00000305AMedicaid
GA00000305SMedicaid
GA00000305BMedicaid
GA00000305AMedicaid
GA00000305SMedicaid