JOHN D. ARCHBOLD MEMORIAL HOSPITAL INC. NPI 1356372304

NPI Information

NPI: 1356372304
Provider Name: JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.

Doing Business As: BROOKS COUNTY DIALYSIS FACILITY

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
101 E DAVIS ST
QUITMAN, GA
ZIP 31643
Phone: (229) 263-6340
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JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. is an end-stage renal disease (esrd) treatment clinic center in Quitman, GA. JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. NPI is 1356372304. The provider is registered as an organization entity type.
The provider Is Doing Business As Brooks County Dialysis Facility.

The provider's business location address is:

101 E DAVIS ST
QUITMAN, GA
ZIP 31643-407
Phone: (229) 263-6340
Fax: (229) 263-6330

The provider's authorized official is Gregory S. Hembree .
The authorized official title is Cfo and has the following contact phone number (229) 228-2880.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 3/8/2017.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	ESRD004044	GEORGIA	Yes

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
1	113500	MEDICARE OSCAR/CERTIFICATION	GEORGIA
2	000407294A	MEDICAID	GEORGIA

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: 5/5/2024

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