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General NPI Number Information
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NPI Number | 1346510443
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Entity Type | Organization
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Legal Business Name | PUTNAM GENERAL HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 101 LAKE OCONEE PKWY
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City | EATONTON
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State | GA
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Zip | 31024-6054
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Country | US
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Telephone | 706-485-2711
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Fax | 706-923-2158
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Provider Business Mailing Address
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Address Line | 101 LAKE OCONEE PKWY
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City | EATONTON
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State | GA
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Zip | 31024-6054
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Country | US
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Telephone | 706-485-2711
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Fax | 706-923-2158
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Authorized Official
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Title or Position | CEO
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Name | JAMES ALAN HORTON
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Credential |
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Telephone | 706-923-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHRE008587
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License Number State | GA
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