MEDICARE: TIFT REGIONAL HEALTH SYSTEM, INC.

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	282N00000X	General Acute Care Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000306	OTHER	GA	BLUE CROSS

General Provider Information

NPI Number	:	1568410264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIFT REGIONAL HEALTH SYSTEM, INC.

Provider Business Mailing Address
First Line	:	260 MJ TAYLOR RD
Second Line	:
City	:	ADEL
State	:	GA
Zip	:	31620-3485
Country	:	US
Telephone Number	:	229-896-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	260 MJ TAYLOR RD
Second Line	:
City	:	ADEL
State	:	GA
Zip	:	31620-3485
Country	:	US
Telephone Number	:	229-896-8159
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	CHRISTOPHER DORMAN
Credential	:
Telephone Number	:	229-353-6104

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	06/24/2022

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