Provider Demographics
NPI:1851696710
Name:EFFINGHAM HOSPITAL, INC.
Entity Type:Organization
Organization Name:EFFINGHAM HOSPITAL, INC.
Other - Org Name:ECB OCCUPATIONAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER-WITT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA, CNHA
Authorized Official - Phone:912-754-0142
Mailing Address - Street 1:459 HIGHWAY 119 SOUTH
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:GA
Mailing Address - Zip Code:31329
Mailing Address - Country:US
Mailing Address - Phone:912-754-0175
Mailing Address - Fax:912-754-6395
Practice Address - Street 1:110 GOSHEN RD
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5545
Practice Address - Country:US
Practice Address - Phone:912-826-1500
Practice Address - Fax:912-826-1531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAHOSP150Medicare PIN