MEDICARE: THE MEDICAL CENTER OF PEACH COUNTY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282NC0060X	Critical Access Hospital	111-136	GA

General Provider Information

NPI Number	:	1114923406
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MEDICAL CENTER OF PEACH COUNTY, INC

Provider Business Mailing Address
First Line	:	1960 HWY 247 CONNECTOR
Second Line	:
City	:	BYRON
State	:	GA
Zip	:	31008-5663
Country	:	US
Telephone Number	:	478-654-2000
Fax Number	:	478-654-2001

Provider Business Practice Location Address
First Line	:	1960 HWY 247 CONNECTOR
Second Line	:
City	:	BYRON
State	:	GA
Zip	:	31008-5663
Country	:	US
Telephone Number	:	478-654-2000
Fax Number	:	478-654-2001

Authorized Official
Title or Position	:	CFO
Name	:	PHILIP WHEELER
Credential	:
Telephone Number	:	706-509-3012

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	09/29/2025

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