Healthcare Provider Details

I. General information

NPI: 1770881567
Provider Name (Legal Business Name): AUGUSTA HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 02/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 WRIGHTSBORO RD
AUGUSTA GA
30904-4764
US

IV. Provider business mailing address

4000 MERIDIAN BLVD
FRANKLIN TN
37067-6325
US

V. Phone/Fax

Practice location:
  • Phone: 706-481-7450
  • Fax: 706-481-7532
Mailing address:
  • Phone: 615-628-6038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SOPHIA L ARWOOD
Title or Position: DIRECTOR
Credential:
Phone: 615-628-6038