Provider Demographics
NPI:1265521769
Name:THOMASTON HOSPICE, INC.
Entity type:Organization
Organization Name:THOMASTON HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:HINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-647-2273
Mailing Address - Street 1:310 N CHURCH ST STE D
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-6301
Mailing Address - Country:US
Mailing Address - Phone:706-647-2273
Mailing Address - Fax:706-646-3858
Practice Address - Street 1:310 N CHURCH ST STE D
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-6301
Practice Address - Country:US
Practice Address - Phone:706-647-2273
Practice Address - Fax:706-646-3858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA145-172-H251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA111596Medicare ID - Type Unspecified