MEDICARE: HOSPITAL AUTHORITY OF EFFINGHAM COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302R00000X	Health Maintenance Organization		GA

General Provider Information

NPI Number	:	1184800435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL AUTHORITY OF EFFINGHAM COUNTY

Provider Business Mailing Address
First Line	:	100 GOSHEN RD
Second Line	:
City	:	RINCON
State	:	GA
Zip	:	31326-5545
Country	:	US
Telephone Number	:	912-826-6000
Fax Number	:	912-826-6016

Provider Business Practice Location Address
First Line	:	100 GOSHEN RD
Second Line	:
City	:	RINCON
State	:	GA
Zip	:	31326-5545
Country	:	US
Telephone Number	:	912-826-6000
Fax Number	:	912-826-6016

Authorized Official
Title or Position	:	CEO
Name	:	NORMA JEAN MORGAN
Credential	:
Telephone Number	:	912-754-0160

Provider Enumeration Date	:	01/17/2008
Last Update Date	:	01/17/2008

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Directions to “HOSPITAL AUTHORITY OF EFFINGHAM COUNTY ” Practice Location

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