Provider Demographics
NPI:1912951963
Name:DOCTORS HOSPITAL OF AUGUSTA LLC
Entity Type:Organization
Organization Name:DOCTORS HOSPITAL OF AUGUSTA LLC
Other - Org Name:DOCTORS HOSPITAL (AUGUSTA)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-651-6108
Mailing Address - Street 1:3651 WHEELER RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6521
Mailing Address - Country:US
Mailing Address - Phone:706-651-3232
Mailing Address - Fax:706-651-2041
Practice Address - Street 1:3651 WHEELER RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6521
Practice Address - Country:US
Practice Address - Phone:706-651-3232
Practice Address - Fax:706-651-2041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
156164500OtherDEPT OF LABOR
WV174493000Medicaid
FL191815Medicaid
CO91401739Medicaid
GA00000558AMedicaid
NY02718918Medicaid
MS220545Medicaid
LA1757641Medicaid
ID807214700Medicaid
AZ912601Medicaid
ALHOS0177NMedicaid
NJ0044555Medicaid
GA138OtherBLUE CROSS
NY191815OtherWELLCARE HMO
SC356425Medicaid
OH358867Medicaid
TN7221OtherBLUECARE
FL92844500Medicaid
CAXHSP30784Medicaid
NC1100177Medicaid
156164500OtherDEPT OF LABOR