SUMTER REGIONAL HOSPITAL NPI 1487719076

NPI Information

NPI: 1487719076
Provider Name: SUMTER REGIONAL HOSPITAL

Doing Business As: ELLAVILLE PRIMARY MEDICINE CENTER

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
72 S. BROAD ST.
ELLAVILLE, GA
ZIP 31806
Phone: (229) 937-5321
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SUMTER REGIONAL HOSPITAL is a rural health clinic center in Ellaville, GA. SUMTER REGIONAL HOSPITAL NPI is 1487719076. The provider is registered as an organization entity type.
The provider Is Doing Business As Ellaville Primary Medicine Center.

The provider's business location address is:

72 S. BROAD ST.
ELLAVILLE, GA
ZIP 31806
Phone: (229) 937-5321
Fax: (229) 937-2232

The provider's authorized official is Maryanne Shepherd .
The authorized official title is Director and has the following contact phone number (229) 937-5321.

The enumeration date for this NPI number is 12/26/2006 and was last updated on 8/22/2020.

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	261QR1300X	Clinic/Center	Rural Health			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	00000019F	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: 11/14/2023

NPI Synchronization or Removal

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