Provider Demographics
NPI:1245668417
Name:EFFINGHAM HOSPITAL, INC.
Entity type:Organization
Organization Name:EFFINGHAM HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER-WITT
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MBA, LNHA, RN
Authorized Official - Phone:912-754-0175
Mailing Address - Street 1:459 HIGHWAY 119 SOUTH
Mailing Address - Street 2:ATTN.: ALIA ALLEN/MEDICAL STAFF OFFICE
Mailing Address - City:SPRINGFIELD
Mailing Address - State:GA
Mailing Address - Zip Code:31329
Mailing Address - Country:US
Mailing Address - Phone:912-754-0175
Mailing Address - Fax:912-754-6395
Practice Address - Street 1:7306 GA HIGHWAY 21 STE 105
Practice Address - Street 2:
Practice Address - City:PORT WENTWORTH
Practice Address - State:GA
Practice Address - Zip Code:31407-9275
Practice Address - Country:US
Practice Address - Phone:912-966-2575
Practice Address - Fax:912-966-0906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAHOSP150Medicare PIN