Healthcare Provider Details

I. General information

NPI: 1093788424
Provider Name (Legal Business Name): THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 E TOLLISON ST
BAXLEY GA
31513-0120
US

IV. Provider business mailing address

PO BOX 2070
BAXLEY GA
31515-2070
US

V. Phone/Fax

Practice location:
  • Phone: 912-367-9841
  • Fax: 912-367-4776
Mailing address:
  • Phone: 912-367-9841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberPHRE006932
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARIE BARNES
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 912-367-9841