Provider Demographics
NPI:1396877395
Name:CALHOUN MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:CALHOUN MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:55 R E JENNINGS AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:39813
Mailing Address - Country:US
Mailing Address - Phone:229-725-4272
Mailing Address - Fax:229-725-4299
Practice Address - Street 1:55 R E JENNINGS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:GA
Practice Address - Zip Code:39813
Practice Address - Country:US
Practice Address - Phone:229-725-4272
Practice Address - Fax:229-725-4299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00000305BMedicaid