Provider Demographics
NPI:1508985714
Name:THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY
Entity Type:Organization
Organization Name:THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:H
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-839-4000
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:DEMOREST
Mailing Address - State:GA
Mailing Address - Zip Code:30535-0037
Mailing Address - Country:US
Mailing Address - Phone:706-754-3113
Mailing Address - Fax:706-754-7300
Practice Address - Street 1:111 HABERSHAM TERRACE GDNS
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-4558
Practice Address - Country:US
Practice Address - Phone:706-754-3113
Practice Address - Fax:706-754-7300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-28
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA068-04341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00000877BMedicaid
GA00000877BMedicaid