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General NPI Number Information
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NPI Number | 1386670834
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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 | 06/25/2006
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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 | 706-923-2002
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Fax | 706-485-2702
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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 | 706-923-2002
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Fax | 706-485-2702
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | ANITA CULBERSON
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Credential |
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Telephone | 706-923-2006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 117-216
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License Number State | GA
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