Healthcare Provider Details

I. General information

NPI: 1477893857
Provider Name (Legal Business Name): EFFINGHAM HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2013
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 GA HIGHWAY 119 S
SPRINGFIELD GA
31329-3021
US

IV. Provider business mailing address

459 HWY 119 S
SPRINGFIELD GA
31329-3021
US

V. Phone/Fax

Practice location:
  • Phone: 912-754-0422
  • Fax: 912-754-0305
Mailing address:
  • Phone: 912-754-6451
  • Fax: 912-754-2570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE010321
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberPHH007975
License Number StateGA

VIII. Authorized Official

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