Healthcare Provider Details

I. General information

NPI: 1821017831
Provider Name (Legal Business Name): BACON COUNTY HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E 15TH ST
ALMA GA
31510-2908
US

IV. Provider business mailing address

204 E 15TH ST
ALMA GA
31510-2908
US

V. Phone/Fax

Practice location:
  • Phone: 912-632-2952
  • Fax: 912-632-8682
Mailing address:
  • Phone: 912-632-2952
  • Fax: 912-632-8682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MS. MELISSA FIVEASH
Title or Position: OFFICE MANAGER/DIRECTOR
Credential:
Phone: 912-632-2952