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General NPI Number Information
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NPI Number | 1871696260
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Entity Type | Organization
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Legal Business Name | THE COBB FOUNDATION, INC.
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 138 W GIBSON ST
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City | HARTWELL
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State | GA
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Zip | 30643-1847
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Country | US
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Telephone | 706-856-6100
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Fax | 706-856-6294
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Provider Business Mailing Address
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Address Line | PO BOX 280
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City | HARTWELL
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State | GA
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Zip | 30643-0280
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Country | US
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Telephone | 706-856-6100
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Fax | 706-856-6117
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MR. JERRY R WISE
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Credential |
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Telephone | 706-856-6113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 073-494
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License Number State | GA
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