Provider Demographics
NPI:1760452098
Name:HOSPITAL AUTHORITY OF JENKINS COUNTY
Entity Type:Organization
Organization Name:HOSPITAL AUTHORITY OF JENKINS COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTOINE
Authorized Official - Middle Name:
Authorized Official - Last Name:POYTHRESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-982-4221
Mailing Address - Street 1:931 E WINTHROPE AVE
Mailing Address - Street 2:
Mailing Address - City:MILLEN
Mailing Address - State:GA
Mailing Address - Zip Code:30442-1839
Mailing Address - Country:US
Mailing Address - Phone:478-982-4221
Mailing Address - Fax:478-982-2478
Practice Address - Street 1:931 E WINTHROPE AVE
Practice Address - Street 2:
Practice Address - City:MILLEN
Practice Address - State:GA
Practice Address - Zip Code:30442-1839
Practice Address - Country:US
Practice Address - Phone:478-982-4221
Practice Address - Fax:478-982-2478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA082-270282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA111311Medicare Oscar/Certification
GA11Z311Medicare Oscar/Certification