MEDICARE: HOSPITAL AUTHORITY OF WILKES COUNTY

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	157-200	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619961695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL AUTHORITY OF WILKES COUNTY

Provider Business Mailing Address
First Line	:	120 GORDON ST
Second Line	:
City	:	WASHINGTON
State	:	GA
Zip	:	30673-1602
Country	:	US
Telephone Number	:	706-678-2151
Fax Number	:	706-678-1546

Provider Business Practice Location Address
First Line	:	120 GORDON ST
Second Line	:
City	:	WASHINGTON
State	:	GA
Zip	:	30673-1602
Country	:	US
Telephone Number	:	706-678-2151
Fax Number	:	706-678-1546

Authorized Official
Title or Position	:	CFO
Name	:	TRACIE BURRISS
Credential	:
Telephone Number	:	706-678-9213

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	02/14/2025

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Directions to “HOSPITAL AUTHORITY OF WILKES COUNTY ” Practice Location

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