Healthcare Provider Details

I. General information

NPI: 1801128863
Provider Name (Legal Business Name): HOSPITAL AUTHORITY OF WILKES COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2010
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 N WASHINGTON ST SUITE A
LINCOLNTON GA
30817-6037
US

IV. Provider business mailing address

611 N WASHINGTON ST STE A
LINCOLNTON GA
30817-6037
US

V. Phone/Fax

Practice location:
  • Phone: 706-359-4215
  • Fax: 706-359-1662
Mailing address:
  • Phone: 706-359-4215
  • Fax: 706-359-1662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TRACIE P HAUGHEY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 706-678-9212