Provider Demographics
NPI:1487219192
Name:MORGAN COUNTY, GEORGIA HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:MORGAN COUNTY, GEORGIA HOSPITAL AUTHORITY
Other - Org Name:MORGAN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:AMADO
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-752-2247
Mailing Address - Street 1:1740 LIONS CLUB ROAD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:GA
Mailing Address - Zip Code:30650
Mailing Address - Country:US
Mailing Address - Phone:706-342-1667
Mailing Address - Fax:706-342-2046
Practice Address - Street 1:1740 LIONS CLUB ROAD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:GA
Practice Address - Zip Code:30650
Practice Address - Country:US
Practice Address - Phone:706-342-1667
Practice Address - Fax:706-342-2046
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORGAN COUNTY, GEORGIA HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-08
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy