Provider Demographics
NPI:1952319642
Name:PHOEBE PUTNEY MEMORIAL HOSPTIAL, INC.
Entity Type:Organization
Organization Name:PHOEBE PUTNEY MEMORIAL HOSPTIAL, INC.
Other - Org Name:TOWER MEDICAL GROUP AT MEREDYTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-312-6704
Mailing Address - Street 1:PO BOX 1828
Mailing Address - Street 2:417 W. 3RD AVENUE
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31702-1828
Mailing Address - Country:US
Mailing Address - Phone:229-312-6761
Mailing Address - Fax:229-312-6705
Practice Address - Street 1:2709 MEREDYTH DRIVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-0222
Practice Address - Country:US
Practice Address - Phone:229-312-9651
Practice Address - Fax:229-312-9655
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHOEBE PUTNEY MEMORIAL HOSPTIAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-04
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty