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General NPI Number Information
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NPI Number | 1194141549
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Entity Type | Organization
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Legal Business Name | HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 138 W THIGPEN AVE
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City | LAKELAND
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State | GA
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Zip | 31635-1011
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Country | US
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Telephone | 229-482-8421
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Fax | 229-482-8543
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Provider Business Mailing Address
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Address Line | PO BOX 9
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City | VALDOSTA
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State | GA
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Zip | 31603-0009
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Country | US
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Telephone | 229-482-8421
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Fax | 229-482-8543
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Authorized Official
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Title or Position | CONTROLLER
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Name | JULIE W HODGES
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Credential |
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Telephone | 229-259-4140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 1-086-2043
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License Number State | GA
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