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NPI Code Detail

MEDICARE: BROOKS COUNTY HOSPITAL

MEDICARE: BROOKS COUNTY HOSPITAL
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
1282NC0060XCritical Access Hospital014-428GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000020OTHERGABC/BS GA
2111332A000000OTHERGATRAILBLAZER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306890942
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOKS COUNTY HOSPITAL
Provider Business Mailing Address
First Line : 920 CAIRO RD
Second Line :
City : THOMASVILLE
State : GA
Zip : 31792-4255
Country : US
Telephone Number : 229-228-8800
Fax Number : 229-228-8892
Provider Business Practice Location Address
First Line : 903 N COURT ST
Second Line :
City : QUITMAN
State : GA
Zip : 31643-1315
Country : US
Telephone Number : 229-263-4171
Fax Number :
Authorized Official
Title or Position : CFO
Name : MR. GREGORY S. HEMBREE
Credential :
Telephone Number : 229-228-2880
Provider Enumeration Date : 05/19/2006
Last Update Date : 03/08/2017

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Directions to “BROOKS COUNTY HOSPITAL ” Practice Location

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