Healthcare Provider Details

I. General information

NPI: 1003099250
Provider Name (Legal Business Name): HOSPITAL AUTHORITY OF WASHINGTON COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 SPARTA RD
SANDERSVILLE GA
31082-1860
US

IV. Provider business mailing address

610 SPARTA RD
SANDERSVILLE GA
31082-1860
US

V. Phone/Fax

Practice location:
  • Phone: 478-240-2060
  • Fax:
Mailing address:
  • Phone: 478-240-2060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number StateGA

VIII. Authorized Official

Name: PAMELA L STEWART
Title or Position: CEO
Credential:
Phone: 478-240-2100