Provider Demographics
NPI:1801901723
Name:HOSPITAL AUTHORITY OF THE CITY OF BAINBRIDGE AND DECATUR COUNTY
Entity type:Organization
Organization Name:HOSPITAL AUTHORITY OF THE CITY OF BAINBRIDGE AND DECATUR COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-243-6109
Mailing Address - Street 1:603 WHEAT AVE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-4360
Mailing Address - Country:US
Mailing Address - Phone:229-243-8597
Mailing Address - Fax:229-243-1506
Practice Address - Street 1:603 WHEAT AVE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-4360
Practice Address - Country:US
Practice Address - Phone:229-243-8597
Practice Address - Fax:229-243-1506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA171028458AMedicaid
GA5536340001Medicare NSC
GA18BDGHWMedicare ID - Type Unspecified
GA171028458AMedicaid