Healthcare Provider Details

I. General information

NPI: 1649247974
Provider Name (Legal Business Name): DOUGLAS HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 10/31/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8954 HOSPITAL DR
DOUGLASVILLE GA
30134-2272
US

IV. Provider business mailing address

793 SAWYER RD
MARIETTA GA
30062-2222
US

V. Phone/Fax

Practice location:
  • Phone: 770-949-1500
  • Fax: 770-792-1784
Mailing address:
  • Phone: 470-644-0012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY J BUDZINSKI
Title or Position: EVP AND CHIEF FINANCIAL OFFICER
Credential:
Phone: 470-644-0012