CARTERSVILLE MEDICAL CENTER LLC

Provider Demographics

• NPI: 1780638833
• Name: CARTERSVILLE MEDICAL CENTER LLC
• Entity type: Organization
• Organization Name: CARTERSVILLE MEDICAL CENTER LLC
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: VP GOVERNMENT REIMBURSEMENT
• Authorized Official - First Name: ROBERT
• Authorized Official - Middle Name: C
• Authorized Official - Last Name: CROSS
• Authorized Official - Phone: 470-271-3401
• Mailing Address - Street 1: 960 JOE FRANK HARRIS PKWY SE
• Mailing Address - City: CARTERSVILLE
• Mailing Address - State: GA
• Mailing Address - Zip Code: 30120-2129
• Mailing Address - Country: US
• Mailing Address - Phone: 770-382-1530
• Mailing Address - Fax: 770-606-2127
• Practice Address - Street 1: 960 JOE FRANK HARRIS PKWY SE
• Practice Address - City: CARTERSVILLE
• Practice Address - State: GA
• Practice Address - Zip Code: 30120-2129
• Practice Address - Country: US
• Practice Address - Phone: 770-382-1530
• Practice Address - Fax: 770-606-2127
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-05-22
• Last Update Date: 2024-02-26

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	282N00000X	Hospitals	General Acute Care Hospital

Provider Identifiers

State	Identifier ID	ID Type	Issuer
AZ	089328	Medicaid
SC	11066A	Medicaid
	158337300	Other	DEPT OF LABOR
FL	911642700	Medicaid
AL	EMO0030N	Medicaid
WI	82554300	Medicaid
GA	000001625A	Medicaid
PA	0018091580003	Medicaid
TN	0110030	Medicaid
KY	01300318	Medicaid
TX	146981901	Medicaid
NV	100504458	Medicaid
MI	1012487	Medicaid
OH	2339222	Medicaid
CO	29686521	Medicaid
TN	3075476	Other	BLUECARE
ND	01698	Medicaid
LA	1704857	Medicaid
OR	269740	Medicaid
GA	3570	Other	BLUE CROSS
NJ	60022246	Medicaid
MS	04935056	Medicaid
KY	1131399	Medicaid
NJ	60022246	Medicaid
NJ	60022246	Medicaid