Provider Demographics
NPI:1861661761
Name:UNION GENERAL HOSPITAL
Entity Type:Organization
Organization Name:UNION GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:T
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-745-2111
Mailing Address - Street 1:214 HOSPITAL CIR
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-3102
Mailing Address - Country:US
Mailing Address - Phone:706-745-2111
Mailing Address - Fax:706-745-7677
Practice Address - Street 1:214 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-3102
Practice Address - Country:US
Practice Address - Phone:706-745-2111
Practice Address - Fax:706-745-7677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA144-533275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00001966AMedicaid