Healthcare Provider Details

I. General information

NPI: 1245446699
Provider Name (Legal Business Name): BACON COUNTY HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 S WAYNE ST
ALMA GA
31510-2922
US

IV. Provider business mailing address

302 S WAYNE ST P O DRAWER 1987
ALMA GA
31510-2922
US

V. Phone/Fax

Practice location:
  • Phone: 912-632-8961
  • Fax: 912-632-5000
Mailing address:
  • Phone: 912-632-8961
  • Fax: 912-632-5000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number003-010
License Number StateGA

VIII. Authorized Official

Name: MRS. CINDY TURNER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 912-632-8961