John D. Archbold Memorial Hospital, Inc.
Organization Active NPI Rural Health Clinic/Center · Coolidge, GA
NPI 1114014669 · NPPES record last updated May 7, 2008
Key facts
- NPI
- 1114014669
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 136-91 (GA)
- Legal business name
- JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.
- Practice address
- 1034 South Pine Street
Coolidge, GA 31738 - Phone
- (229) 346-3511
- Fax
- (229) 346-3512
- NPI assigned
- Oct 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Charles D. Hightower Jr.
- Title
- Cfo
- Phone
- (229) 228-2853
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 136-91 | GA | Yes |
Addresses
Primary practice location
1034 South Pine Street
Coolidge, GA 31738
Mailing address
920 Cairo Rd
Thomasville, GA 31792-4255
Phone (229) 228-8800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000063F | Medicaid | GA |
Other names
- Coolidge Primary Care Clinic
Other providers in Coolidge, GA
- Amanda Gandy
- Damon Graham Jr.
- Sylvia Holmes
- Catherine Basford Howell
- Tamara A Iacampo
- Premise Health of Georgia Medical PC
All providers in Coolidge, GA · Rural Health Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.