Provider Demographics
NPI:1942701248
Name:THE BAXLEY APPLING COUNTY HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:THE BAXLEY APPLING COUNTY HOSPITAL AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:FAUSETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-367-9841
Mailing Address - Street 1:163 E TOLLISON ST
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31513-0120
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 WILDES STREET
Practice Address - Street 2:
Practice Address - City:SURRENCEY
Practice Address - State:GA
Practice Address - Zip Code:31513
Practice Address - Country:US
Practice Address - Phone:912-367-9841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty