Healthcare Provider Details

I. General information

NPI: 1720098791
Provider Name (Legal Business Name): IRWIN COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 N IRWIN AVE
OCILLA GA
31774-5011
US

IV. Provider business mailing address

710 N IRWIN AVE
OCILLA GA
31774-5011
US

V. Phone/Fax

Practice location:
  • Phone: 229-468-3800
  • Fax: 229-468-9991
Mailing address:
  • Phone: 229-468-3800
  • Fax: 229-468-9991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number86112S
License Number StateGA

VIII. Authorized Official

Name: MRS. MARY DEMIAN
Title or Position: CFO
Credential:
Phone: 229-468-3800