WELLSTAR SYLVAN GROVE HOSPITAL INC NPI 1386664779

NPI Information

NPI: 1386664779
Provider Name: WELLSTAR SYLVAN GROVE HOSPITAL, INC

Doing Business As: SYLVAN GROVE HOSPITAL

Classification: General Acute Care Hospital - 282NC0060X
Entity Type: Organization

Specialization: Critical Access

Address:
1050 MCDONOUGH RD
JACKSON, GA
ZIP 30233
Phone: (770) 775-7861
Get Directions

WELLSTAR SYLVAN GROVE HOSPITAL, INC is a critical access general acute care hospital in Jackson, GA. WELLSTAR SYLVAN GROVE HOSPITAL, INC NPI is 1386664779. The provider is registered as an organization entity type.
The provider Is Doing Business As Sylvan Grove Hospital.

The provider's business location address is:

1050 MCDONOUGH RD
JACKSON, GA
ZIP 30233-524
Phone: (770) 775-7861

The provider's authorized official is Anthony J Buzdinski .
The authorized official title is Evp and has the following contact phone number (470) 644-0012.

The CLIA number assigned to this NPI record is 11D0257390 - hospital with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/20/2006 and was last updated on 2/24/2020.

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	282NC0060X	General Acute Care Hospital	Critical Access			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	00282488B	MEDICAID	GEORGIA
2	00495382D	MEDICAID	GEORGIA
3	085001319G	MEDICAID	GEORGIA
4	000444	OTHER		HUMANA
5	00715107T	MEDICAID	GEORGIA
6	010492809(TRR)	MEDICAID	MISSOURI
7	152710726	OTHER		KAISER FOUNDATION HEALTH
8	1703761	MEDICAID	LOUISIANA
9	00001856A	MEDICAID	GEORGIA
10	00211549E	MEDICAID	GEORGIA
11	004378	OTHER		BCBS OF GEORGIA
12	973964590	OTHER		AETNA US HEALTHCARE
13	00001856S	MEDICAID	GEORGIA
14	00214607F	MEDICAID	GEORGIA
15	00791062E	MEDICAID	GEORGIA
16	416159	OTHER		COVENTRY HEALTH CARE GEOR
17	00885024B	MEDICAID	GEORGIA
18	111319B000000	OTHER		SECTION 1011
19	23360	OTHER		COVENTRY HEALTH CARE GEOR

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »