Provider Demographics
NPI:1851355481
Name:GEORGIA DEPARTMENT OF HUMAN RESOURCES
Entity Type:Organization
Organization Name:GEORGIA DEPARTMENT OF HUMAN RESOURCES
Other - Org Name:GEORGIA REGIONAL HOSPITAL SAVANNAH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RHA
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-356-2011
Mailing Address - Street 1:1915 EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-5027
Mailing Address - Country:US
Mailing Address - Phone:912-356-2011
Mailing Address - Fax:912-351-3538
Practice Address - Street 1:1915 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-5027
Practice Address - Country:US
Practice Address - Phone:912-356-2011
Practice Address - Fax:912-351-3538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025-247283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA114028GAMedicare Oscar/Certification
GA114028Medicare Oscar/Certification