JOHN D. ARCHBOLD MEMORIAL HOSPITAL INC. NPI 1114014669

NPI Information

  • NPI: 1114014669
  • Provider Name: JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Doing Business As: COOLIDGE PRIMARY CARE CLINIC
  • Address: 1034 SOUTH PINE STREET
    COOLIDGE, GA
    ZIP 31738
  • Phone: (229) 346-3511

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NPI Details

JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. is a rural health clinic center in Coolidge, GA. JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. NPI is 1114014669. The provider is registered as an organization entity type.
The provider Is Doing Business As Coolidge Primary Care Clinic.

The provider's business location address is:

1034 SOUTH PINE STREET
COOLIDGE, GA
ZIP 31738
Phone: (229) 346-3511
Fax: (229) 346-3512

The provider's authorized official is Charles D. Hightower .
The authorized official title is Cfo and has the following contact phone number (229) 228-2853.

The enumeration date for this NPI number is 10/6/2006 and was last updated on 5/7/2008.

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
1261QR1300XClinic/CenterRural Health136-91GEORGIAYes

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
1000000063FMEDICAIDGEORGIA
2113989MEDICARE OSCAR/CERTIFICATIONGEORGIA

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: 3/30/2025

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