Provider Demographics
NPI:1932175056
Name:HUTCHESON MEDICAL CENTER INC
Entity Type:Organization
Organization Name:HUTCHESON MEDICAL CENTER INC
Other - Org Name:HUTCHESON HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR HOME HEALTH
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:NETHERY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:707-866-8881
Mailing Address - Street 1:100 MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:FT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-3683
Mailing Address - Country:US
Mailing Address - Phone:706-866-8881
Mailing Address - Fax:706-858-3104
Practice Address - Street 1:100 MITCHELL RD
Practice Address - Street 2:
Practice Address - City:FT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3683
Practice Address - Country:US
Practice Address - Phone:706-866-8881
Practice Address - Fax:706-858-3104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA023 184251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0001885523AMedicaid
GA117308Medicare Oscar/Certification