Healthcare Provider Details

I. General information

NPI: 1891588836
Provider Name (Legal Business Name): THE HOSPITAL AUTHORITY OF BROOKS COUNTY, GEORGIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W SCREVEN ST
QUITMAN GA
31643-3913
US

IV. Provider business mailing address

PO BOX 926
QUITMAN GA
31643-0926
US

V. Phone/Fax

Practice location:
  • Phone: 229-263-6100
  • Fax: 229-263-6195
Mailing address:
  • Phone: 229-263-6106
  • Fax: 229-263-6195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: CHAD PEARCE
Title or Position: VP OF FINANCE
Credential:
Phone: 229-263-6189