Provider Demographics
NPI:1821042870
Name:DOCTORS HOSPITAL OF AUGUSTA, LLC
Entity Type:Organization
Organization Name:DOCTORS HOSPITAL OF AUGUSTA, LLC
Other - Org Name:DOCTORS HOSPITAL (AUGUSTA)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-651-6108
Mailing Address - Street 1:3651 WHEELER RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6521
Mailing Address - Country:US
Mailing Address - Phone:706-651-6160
Mailing Address - Fax:706-651-6152
Practice Address - Street 1:3651 WHEELER RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6521
Practice Address - Country:US
Practice Address - Phone:706-651-6160
Practice Address - Fax:706-651-6152
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOCTORS HOSPITAL OF AUGUSTA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-22
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
11T177Medicare Oscar/Certification