Macon County Community Hospital, Inc.

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

094-391 Issued in GA

Legal business name

MACON COUNTY COMMUNITY HOSPITAL, INC.

Practice address

509 Sumter St
Montezuma, GA 31063-1733

Phone

(478) 472-3100

Fax

(478) 472-2412

NPI assigned

Oct 12, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Philip Eastman III

Title

Chief Executive Officer

Phone

(478) 472-3100

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1286841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1922318922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 SUMTER ST",
            "city": "MONTEZUMA",
            "state": "GA",
            "postal_code": "310631733",
            "telephone_number": "478-472-3100",
            "fax_number": "478-472-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 SUMTER ST",
            "city": "MONTEZUMA",
            "state": "GA",
            "postal_code": "310631733",
            "telephone_number": "478-472-3100",
            "fax_number": "478-472-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACON COUNTY COMMUNITY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-12",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "EASTMAN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "478-472-3100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "094-391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000149487A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn C James, LPC
• Quincy Jerome Jordan Sr., MD
• Douglas Ray Joyner, MD
• Donald Keith Lane, RPH
• Shawn L Law, PHARMD
• Macon County Convenient Care
• Macon County Medical Center, Inc Dba Flint River Community Hospital
• Macon County Medical Center, Inc.
• Demetria Anise McDonald
• Medicine Stop LLC (Medicine Stop II)

• General Acute Care Hospital in Montezuma, GA
• Providers in Montezuma, GA by specialty
• General Acute Care Hospital in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.