Healthcare Provider Details

I. General information

NPI: 1194779702
Provider Name (Legal Business Name): JOHN D ARCHBOLD MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 04/30/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 GORDON AVE
THOMASVILLE GA
31792-6614
US

IV. Provider business mailing address

920 CAIRO RD
THOMASVILLE GA
31792-4255
US

V. Phone/Fax

Practice location:
  • Phone: 229-228-2000
  • Fax:
Mailing address:
  • Phone: 229-228-8800
  • Fax: 229-228-8892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number136-91
License Number StateGA

VIII. Authorized Official

Name: MR. GREGORY S. HEMBREE
Title or Position: CFO
Credential:
Phone: 229-228-2880