Healthcare Provider Details

I. General information

NPI: 1841292059
Provider Name (Legal Business Name): HOSPITAL AUTHORITY OF COLUMBUS GA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8414 WHITESVILLE ROAD
COLUMBUS GA
31904
US

IV. Provider business mailing address

8414 WHITESVILLE ROAD
COLUMBUS GA
31904
US

V. Phone/Fax

Practice location:
  • Phone: 706-225-1100
  • Fax: 706-225-1101
Mailing address:
  • Phone: 706-225-1100
  • Fax: 706-225-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1-106-385
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1-106-385
License Number StateGA

VIII. Authorized Official

Name: SAMUEL F MORAST III
Title or Position: PRESIDENT
Credential:
Phone: 706-225-1103