Provider Demographics
NPI:1477695427
Name:GEORGIA INFIRMARY, INC.
Entity Type:Organization
Organization Name:GEORGIA INFIRMARY, INC.
Other - Org Name:ST JOSEPH'S/CANDLER SOURCE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:ALBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-819-1505
Mailing Address - Street 1:1900 ABERCORN STREET
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401
Mailing Address - Country:US
Mailing Address - Phone:912-819-1500
Mailing Address - Fax:912-819-1549
Practice Address - Street 1:1900 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-8139
Practice Address - Country:US
Practice Address - Phone:912-819-1500
Practice Address - Fax:912-819-1549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7483OtherMEDICARE GROUP NUMBER
GA000498209AMedicaid
GA00120205AMedicaid
GA085500200GMedicaid
GA00120205BMedicaid
GA000680314GMedicaid
GA000321626GMedicaid