Provider Demographics
NPI:1265425334
Name:THE BAXLEY APPLING COUNTY HOSPITAL AUTHORITY
Entity type:Organization
Organization Name:THE BAXLEY APPLING COUNTY HOSPITAL AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-367-9841
Mailing Address - Street 1:PO BOX 2070
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31515-2070
Mailing Address - Country:US
Mailing Address - Phone:912-367-9841
Mailing Address - Fax:912-366-9173
Practice Address - Street 1:82 WALNUT ST
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-0119
Practice Address - Country:US
Practice Address - Phone:912-367-9841
Practice Address - Fax:912-366-9173
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APPLING HEALTHCARESYSTEMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-24
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-001-390314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00140093AMedicaid
GA00140093AMedicaid