Provider Demographics
NPI:1417938846
Name:MACON COUNTY GENERAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:MACON COUNTY GENERAL HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT FINANCIAL SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:HALEY
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-666-2147
Mailing Address - Street 1:P O BOX 378
Mailing Address - Street 2:204 MEDICAL DRIVE
Mailing Address - City:LAFAYETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37083-9999
Mailing Address - Country:US
Mailing Address - Phone:615-666-2147
Mailing Address - Fax:615-666-7052
Practice Address - Street 1:305 W LOCUST ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:TN
Practice Address - Zip Code:37083-1712
Practice Address - Country:US
Practice Address - Phone:615-666-2147
Practice Address - Fax:615-666-7052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000080282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1000176OtherBLUE CROSS
TN0441305Medicaid
TN44Z305Medicare ID - Type Unspecified
TN0441305Medicaid