Healthcare Provider Details

I. General information

NPI: 1245867688
Provider Name (Legal Business Name): EFFINGHAM HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 HIGHWAY 119 S
SPRINGFIELD GA
31329-3021
US

IV. Provider business mailing address

459 HIGHWAY 119 S
SPRINGFIELD GA
31329-3021
US

V. Phone/Fax

Practice location:
  • Phone: 912-754-0283
  • Fax: 912-754-4412
Mailing address:
  • Phone: 912-754-0175
  • Fax: 912-754-2570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCINE WITT
Title or Position: CEO
Credential: PHD
Phone: 912-754-0160