NPI Code Details Logo

NPI 1396657912

NPI 1396657912 : UPSON COUNTY HOSPITAL INC. : THOMASTON, GA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1396657912
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    UPSON COUNTY HOSPITAL INC. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/18/2026
-----------------------------------------------------
    Last Update Date     |    09/18/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    915 W GORDON ST STE B 
-----------------------------------------------------
    City                 |    THOMASTON
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30286-3427
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    706-647-7009
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    801 W GORDON ST 
-----------------------------------------------------
    City                 |    THOMASTON
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30286-3426
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    706-647-8111
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CHIEF FINANCIAL OFFICER
-----------------------------------------------------
    Name                 |     JASON ADAM GASSETT 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    706-647-8111
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QR1300X
-----------------------------------------------------
    Taxonomy Name        |    Rural Health Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.