EVANS MEMORIAL HOSPITAL INC. NPI 1104350057

NPI Information

  • NPI: 1104350057
  • Provider Name: EVANS MEMORIAL HOSPITAL, INC.
  • Classification: General Acute Care Hospital - 282N00000X
  • Entity Type: Organization
  • CLIA Number: 11D0260979
  • Address: 200 N RIVER ST
    CLAXTON, GA
    ZIP 30417
  • Phone: (912) 739-2611

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NPI Details

EVANS MEMORIAL HOSPITAL, INC. is a general acute care hospital in Claxton, GA. The provider is an acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. EVANS MEMORIAL HOSPITAL, INC. NPI is 1104350057. The provider is registered as an organization entity type.

The provider's business location address is:

200 N RIVER ST
CLAXTON, GA
ZIP 30417-659
Phone: (912) 739-2611
Fax: (912) 739-5101

The provider's authorized official is John W Wiggins .
The authorized official title is Cfo and has the following contact phone number (912) 739-5139.

The CLIA number assigned to this NPI record is 11D0260979 - hospital with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/18/2017 and was last updated on 4/18/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1282N00000XGeneral Acute Care Hospital054526GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1110142MEDICARE UPINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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