Provider Demographics
NPI:1932194222
Name:WINDER HMA LLC
Entity Type:Organization
Organization Name:WINDER HMA LLC
Other - Org Name:BARROW REGIONAL MEDICAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:P
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-3672
Mailing Address - Street 1:316 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-2187
Mailing Address - Country:US
Mailing Address - Phone:770-867-3400
Mailing Address - Fax:770-307-5215
Practice Address - Street 1:316 N BROAD ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-2150
Practice Address - Country:US
Practice Address - Phone:770-867-3400
Practice Address - Fax:770-307-5215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007-600282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000002098AMedicaid
GA100251OtherBLUE CROSS/BLUE SHIELD
110045Medicare Oscar/Certification