Provider Demographics
NPI:1760436323
Name:DOCTORS HOSPITAL COLUMBUS GA - JOINT VENTURE
Entity Type:Organization
Organization Name:DOCTORS HOSPITAL COLUMBUS GA - JOINT VENTURE
Other - Org Name:DOCTORS HOSPITAL (COLUMBUS)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:SALLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-494-4381
Mailing Address - Street 1:PO BOX 2188
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902-2188
Mailing Address - Country:US
Mailing Address - Phone:706-494-4262
Mailing Address - Fax:706-494-4156
Practice Address - Street 1:616 19TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1528
Practice Address - Country:US
Practice Address - Phone:706-494-4262
Practice Address - Fax:706-494-4156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC11269BMedicaid
KY01301290Medicaid
KY50007837OtherPASSPORT
TN0110186Medicaid
MA1200500Medicaid
GA135OtherBLUE CROSS
OH2414293Medicaid
WI82323800Medicaid
TN7336OtherBLUECARE
ALCOM0186NMedicaid
CAXHSP43761Medicaid
GA00148233AMedicaid
OH2414293Medicaid