Provider Demographics
NPI:1871662692
Name:MERIWETHER COUNTY HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:MERIWETHER COUNTY HOSPITAL AUTHORITY
Other - Org Name:WARM SPRINGS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:FOSTER
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:706-655-9244
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:5995 SPRING STREET
Mailing Address - City:WARM SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:31830-0008
Mailing Address - Country:US
Mailing Address - Phone:706-655-3331
Mailing Address - Fax:706-655-9243
Practice Address - Street 1:5995 SPRING STREET
Practice Address - Street 2:
Practice Address - City:WARM SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:31830-0008
Practice Address - Country:US
Practice Address - Phone:706-655-3331
Practice Address - Fax:706-655-9243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHH007769333600000X
GAPHRE0088573336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00001284AMedicaid
GA112316Medicare ID - Type UnspecifiedEXTENDED CARE PHARMACY
GA111316Medicare ID - Type UnspecifiedHOSPITAL RX