Healthcare Provider Details

I. General information

NPI: 1891315420
Provider Name (Legal Business Name): PHOEBE PUTNEY MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 W 3RD AVE STE 100
ALBANY GA
31701-1956
US

IV. Provider business mailing address

417 W 3RD AVE
ALBANY GA
31701-1943
US

V. Phone/Fax

Practice location:
  • Phone: 229-312-5500
  • Fax: 229-312-5505
Mailing address:
  • Phone: 229-312-5500
  • Fax: 229-312-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: REBECCA KENDALL
Title or Position: REIMBURSEMENT
Credential:
Phone: 229-312-6711