Healthcare Provider Details

I. General information

NPI: 1285794750
Provider Name (Legal Business Name): THE HOSPITAL AUTHORITY OF MILLER COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 11/03/2021
Certification Date: 11/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 N CUTHBERT ST
COLQUITT GA
39837-3518
US

IV. Provider business mailing address

209 N CUTHBERT ST
COLQUITT GA
39837-3518
US

V. Phone/Fax

Practice location:
  • Phone: 229-758-4200
  • Fax: 229-758-5198
Mailing address:
  • Phone: 229-758-4200
  • Fax: 229-758-5198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number100118
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number100118
License Number StateGA

VIII. Authorized Official

Name: MS. ROBIN A RAU
Title or Position: CEO
Credential:
Phone: 229-758-5954