Healthcare Provider Details

I. General information

NPI: 1558339085
Provider Name (Legal Business Name): HUTCHESON MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 08/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GROSS CRESCENT CIRCLE
FORT OGLETHORPE GA
30742-3643
US

IV. Provider business mailing address

100 GROSS CRESCENT CIRCLE
FORT OGLETHORPE GA
30742-3643
US

V. Phone/Fax

Practice location:
  • Phone: 706-858-2000
  • Fax: 706-858-2732
Mailing address:
  • Phone: 706-858-2000
  • Fax: 706-858-2732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number14609
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number023522
License Number StateGA

VIII. Authorized Official

Name: ROGER FORGEY
Title or Position: CEO
Credential:
Phone: 706-858-2000