Healthcare Provider Details

I. General information

NPI: 1790739753
Provider Name (Legal Business Name): PALMYRA PARK HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 06/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PALMYRA RD
ALBANY GA
31701-1528
US

IV. Provider business mailing address

2000 PALMYRA RD
ALBANY GA
31701-1528
US

V. Phone/Fax

Practice location:
  • Phone: 229-434-2000
  • Fax: 229-434-2138
Mailing address:
  • Phone: 229-434-2000
  • Fax: 229-434-2138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: KAREN HAYES
Title or Position: CFO
Credential:
Phone: 229-434-2100