Provider Demographics
NPI:1861480188
Name:HAMILTON MEDICAL CENTER INC
Entity Type:Organization
Organization Name:HAMILTON MEDICAL CENTER INC
Other - Org Name:HAMILTON HOME HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:706-272-6000
Mailing Address - Street 1:1221 ELKWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30722-1168
Mailing Address - Country:US
Mailing Address - Phone:706-226-2848
Mailing Address - Fax:706-272-6661
Practice Address - Street 1:1221 ELKWOOD DR
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8723
Practice Address - Country:US
Practice Address - Phone:706-226-2848
Practice Address - Fax:706-272-6661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA155-012251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00199812AMedicaid
GA117062Medicare Oscar/Certification