Lagrange Troup County Hospital Authority

Primary specialty

Inpatient HospiceTaxonomy code 315D00000X

Legal business name

LAGRANGE TROUP COUNTY HOSPITAL AUTHORITY

Doing business as

West Georgia Hospice

Practice address

1510 Vernon Rd
Lagrange, GA 30240-4131

Phone

(706) 845-3905

Fax

(706) 845-3902

NPI assigned

Feb 15, 2006

Last updated

Oct 31, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gerald N Fulks

Title

President Ceo

Phone

(706) 845-3244

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• West Georgia Hospice Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1174597298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404131",
            "telephone_number": "706-845-3905",
            "fax_number": "706-845-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404131",
            "telephone_number": "706-845-3905",
            "fax_number": "706-845-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGRANGE TROUP COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "FULKS",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "706-845-3244",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00371896A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Georgia Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lagrange Troup County Hospital Authority (Twin Fountains Home)
• Lagrange Troup County Hospital Authority (West Georgia Medical Center DME)
• Lagrange Troup County Hospital Authority (West Georgia Home Care)
• Lagrange Troup County Hospital Authority (West Georgia Dialysis)
• Lagrange Troup County Hospital Authority (Florence Hand Home)

• Inpatient Hospice in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Inpatient Hospice in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.