Healthcare Provider Details

I. General information

NPI: 1750686382
Provider Name (Legal Business Name): EFFINGHAM HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2011
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 HIGHWAY 21 S STE H
SPRINGFIELD GA
31329-5244
US

IV. Provider business mailing address

459 HIGHWAY 119 SOUTH ATTN.: ALIA ALLEN/MEDICAL STAFF OFFICE
SPRINGFIELD GA
31329
US

V. Phone/Fax

Practice location:
  • Phone: 912-754-1035
  • Fax:
Mailing address:
  • Phone: 912-754-0175
  • Fax: 912-754-6395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateGA

VIII. Authorized Official

Name: MRS. FRANCINE BAKER-WITT
Title or Position: CEO
Credential: RN, MBA, CNHA
Phone: 912-754-0142