Provider Demographics
NPI:1982600540
Name:UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC.
Other - Org Name:PIEDMONT MCDUFFIE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, GOVERNMENT REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-271-3401
Mailing Address - Street 1:2460 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-6600
Mailing Address - Country:US
Mailing Address - Phone:706-597-5201
Mailing Address - Fax:706-597-5139
Practice Address - Street 1:2460 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-6600
Practice Address - Country:US
Practice Address - Phone:706-597-5201
Practice Address - Fax:706-597-5139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000001185AMedicaid
GA000001185BMedicaid
GA110111Medicare ID - Type Unspecified