Provider Demographics
NPI:1598531907
Name:SOUTH GEORGIA MEDICAL CENTER INC
Entity Type:Organization
Organization Name:SOUTH GEORGIA MEDICAL CENTER INC
Other - Org Name:SOUTH GEORGIA MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:W
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-259-4140
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31603-0009
Mailing Address - Country:US
Mailing Address - Phone:229-245-6232
Mailing Address - Fax:
Practice Address - Street 1:2501 N PATTERSON ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1735
Practice Address - Country:US
Practice Address - Phone:229-433-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH GEORGIA MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-27
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit