Provider Demographics
NPI:1841292059
Name:HOSPITAL AUTHORITY OF COLUMBUS GA
Entity type:Organization
Organization Name:HOSPITAL AUTHORITY OF COLUMBUS GA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:MORAST
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:706-225-1103
Mailing Address - Street 1:8414 WHITESVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904
Mailing Address - Country:US
Mailing Address - Phone:706-225-1100
Mailing Address - Fax:706-225-1101
Practice Address - Street 1:8414 WHITESVILLE ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:706-225-1100
Practice Address - Fax:706-225-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-106-385332B00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000142117CMedicaid
GA000142117CMedicaid
GA115146Medicare Oscar/Certification