Healthcare Provider Details

I. General information

NPI: 1053400689
Provider Name (Legal Business Name): BACON CO. HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3406 WILDWOOD AVE.
PATTERSON GA
31557-5065
US

IV. Provider business mailing address

3406 WILDWOOD AVE.
PATTERSON GA
31557-5065
US

V. Phone/Fax

Practice location:
  • Phone: 912-647-2952
  • Fax:
Mailing address:
  • Phone: 912-647-2952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. CINDY R. TURNER
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 912-632-8961