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NPI Code Detail

MEDICARE: JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.

MEDICARE: JOHN D. ARCHBOLD MEMORIAL HOSPITAL, 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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/CenterESRD001128GA

Other Identifiers

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

General Provider Information

NPI Number : 1962433912
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.
Provider Business Mailing Address
First Line : 920 CAIRO RD
Second Line :
City : THOMASVILLE
State : GA
Zip : 31792-4255
Country : US
Telephone Number : 229-228-8800
Fax Number : 229-228-8892
Provider Business Practice Location Address
First Line : 1182 5TH ST SE
Second Line :
City : CAIRO
State : GA
Zip : 39828-3141
Country : US
Telephone Number : 229-377-9606
Fax Number : 229-377-8804
Authorized Official
Title or Position : CFO
Name : MR. GREGORY S. HEMBREE
Credential :
Telephone Number : 229-228-2880
Provider Enumeration Date : 07/06/2006
Last Update Date : 03/03/2017

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