Provider Demographics
NPI:1376118505
Name:HOSPITAL AUTHORITY OF CANDLER COUNTY
Entity Type:Organization
Organization Name:HOSPITAL AUTHORITY OF CANDLER COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLUCK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-685-1769
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:
Mailing Address - City:METTER
Mailing Address - State:GA
Mailing Address - Zip Code:30439-0597
Mailing Address - Country:US
Mailing Address - Phone:912-685-5741
Mailing Address - Fax:912-685-3905
Practice Address - Street 1:400 CEDAR ST
Practice Address - Street 2:
Practice Address - City:METTER
Practice Address - State:GA
Practice Address - Zip Code:30439-3338
Practice Address - Country:US
Practice Address - Phone:912-685-5741
Practice Address - Fax:912-685-3905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care