Healthcare Provider Details

I. General information

NPI: 1699862953
Provider Name (Legal Business Name): TAYLOR REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 PERRY HIGHWAY
HAWKINSVILLE GA
31036-6738
US

IV. Provider business mailing address

P.O. BOX 1297 222 PERRY HIGHWAY
HAWKINSVILLE GA
31036-6738
US

V. Phone/Fax

Practice location:
  • Phone: 478-783-0292
  • Fax: 478-892-8116
Mailing address:
  • Phone: 478-783-0292
  • Fax: 478-892-8116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. EUGENE R. MCDANNALD JR.
Title or Position: INTERIM CEO
Credential: M.D.
Phone: 478-783-0261