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General NPI Number Information
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NPI Number | 1780023911
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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 | 06/20/2013
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 4280 N VALDOSTA RD
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City | VALDOSTA
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State | GA
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Zip | 31602-6814
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Country | US
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Telephone | 229-433-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 0070
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City | VALDOSTA
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State | GA
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Zip | 31603-0070
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Country | US
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Telephone | 229-433-8000
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JACK RANDALL SAULS
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Credential |
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Telephone | 229-333-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 092-141
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License Number State | GA
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