Healthcare Provider Details

I. General information

NPI: 1578637526
Provider Name (Legal Business Name): BLECKLEY COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 E PEACOCK ST
COCHRAN GA
31014-7846
US

IV. Provider business mailing address

PO BOX 536 145 EAST PEACOCK STREET
COCHRAN GA
31014-0536
US

V. Phone/Fax

Practice location:
  • Phone: 478-934-6211
  • Fax:
Mailing address:
  • Phone: 478-934-6211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number012-233
License Number StateGA

VIII. Authorized Official

Name: MRS. NICOLE NOBLES PAULK
Title or Position: CEO
Credential: RN, MSN
Phone: 478-934-6211