Healthcare Provider Details

I. General information

NPI: 1306276324
Provider Name (Legal Business Name): HOSPITAL AUTHORITY OF CANDLER COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2013
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380B CEDAR ST
METTER GA
30439-4042
US

IV. Provider business mailing address

PO BOX 597
METTER GA
30439-0597
US

V. Phone/Fax

Practice location:
  • Phone: 912-685-1215
  • Fax: 912-685-1216
Mailing address:
  • Phone: 912-685-5741
  • Fax: 912-685-3905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL PURVIS
Title or Position: CEO
Credential:
Phone: 912-685-1704