Provider Demographics
NPI:1437536372
Name:UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC
Other - Org Name:UNIVERSITY HOSPITAL MCDUFFIE--SWINGBED UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP GOVERNMENT REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-271-3401
Mailing Address - Street 1:2460 WASHINGTON ROAD NE
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-2199
Mailing Address - Country:US
Mailing Address - Phone:706-595-1411
Mailing Address - Fax:706-597-5139
Practice Address - Street 1:2460 WASHINGTON ROAD NE
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-2199
Practice Address - Country:US
Practice Address - Phone:706-595-1411
Practice Address - Fax:706-597-5139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-29
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00001185Medicaid
11-0111OtherPARENT MEDICARE CCN