Provider Demographics
NPI:1386640324
Name:HOSPITAL AUTHORITY OF COLUMBUS, GA
Entity Type:Organization
Organization Name:HOSPITAL AUTHORITY OF COLUMBUS, GA
Other - Org Name:MUSCOGEE HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:K
Authorized Official - Last Name:HECHT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:706-561-0855
Mailing Address - Street 1:1725 WILLIAMS ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-1601
Mailing Address - Country:US
Mailing Address - Phone:706-561-0855
Mailing Address - Fax:706-561-6543
Practice Address - Street 1:1725 WILLIAMS ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-1601
Practice Address - Country:US
Practice Address - Phone:706-561-0855
Practice Address - Fax:706-561-6543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA106-227251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00811962AMedicaid
GA00811962AMedicaid