Provider Demographics
NPI:1972525186
Name:CALHOUN MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:CALHOUN MEMORIAL HOSPITAL
Other - Org Name:CALHOUN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOM
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:W
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-725-4272
Mailing Address - Street 1:PO BOX R
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:39813-0496
Mailing Address - Country:US
Mailing Address - Phone:229-725-4272
Mailing Address - Fax:229-725-4299
Practice Address - Street 1:17432 SOUTH HIGHLAND AVE.
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:GA
Practice Address - Zip Code:39813-0486
Practice Address - Country:US
Practice Address - Phone:229-725-3135
Practice Address - Fax:229-725-4029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA118515Medicare ID - Type Unspecified