MEDICARE: HOSPITAL AUTHORITY OF JENKINS 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	282NC0060X	Critical Access Hospital	082-270	GA

General Provider Information

NPI Number	:	1760452098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL AUTHORITY OF JENKINS COUNTY

Provider Business Mailing Address
First Line	:	931 E WINTHROPE AVE
Second Line	:
City	:	MILLEN
State	:	GA
Zip	:	30442-1839
Country	:	US
Telephone Number	:	478-982-4221
Fax Number	:	478-982-2478

Provider Business Practice Location Address
First Line	:	931 E WINTHROPE AVE
Second Line	:
City	:	MILLEN
State	:	GA
Zip	:	30442-1839
Country	:	US
Telephone Number	:	478-982-4221
Fax Number	:	478-982-2478

Authorized Official
Title or Position	:	CEO
Name	:	MR. ANTOINE POYTHRESS
Credential	:
Telephone Number	:	478-982-4221

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	05/05/2021

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1497064679 — JENKINS COUNTY HOSPITAL LLC
Practice Location Address:

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Directions to “HOSPITAL AUTHORITY OF JENKINS COUNTY ” Practice Location

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