Provider Demographics
NPI:1770684284
Name:THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA
Entity Type:Organization
Organization Name:THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA
Other - Org Name:MONROE COUNTY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-994-2521
Mailing Address - Street 1:PO BOX 1068
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-1068
Mailing Address - Country:US
Mailing Address - Phone:478-994-2521
Mailing Address - Fax:478-994-8798
Practice Address - Street 1:88 MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-1682
Practice Address - Country:US
Practice Address - Phone:478-994-2521
Practice Address - Fax:478-994-8798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA102121282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00001361AMedicaid
GA203585Medicaid
GA11Z318Medicare Oscar/Certification
GA00001361AMedicaid