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NPI Code Detail

MEDICARE: TMC/VILLA RICA HOSPITAL, INC

MEDICARE: TMC/VILLA RICA HOSPITAL, 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
1261QA1903XAmbulatory Surgical Clinic/Center
2282N00000XGeneral Acute Care Hospital022-424GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851388748
Entity Type Code : Organization
Provider Name (Legal Business Name) : TMC/VILLA RICA HOSPITAL, INC
Provider Business Mailing Address
First Line : PO BOX 638
Second Line :
City : VILLA RICA
State : GA
Zip : 30180-0638
Country : US
Telephone Number : 770-836-9666
Fax Number : 770-456-3390
Provider Business Practice Location Address
First Line : 601 DALLAS HWY
Second Line :
City : VILLA RICA
State : GA
Zip : 30180-1202
Country : US
Telephone Number : 770-456-3000
Fax Number : 770-456-3390
Authorized Official
Title or Position : CFO
Name : CAROL S. CREWS
Credential :
Telephone Number : 770-812-9745
Provider Enumeration Date : 10/05/2005
Last Update Date : 11/19/2025

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