JOHN D. ARCHBOLD MEMORIAL HOSPITAL INC. NPI 1962433912

NPI Information

NPI: 1962433912
Provider Name: JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.

Doing Business As: GRADY COUNTY DIALYSIS FACILITY

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
1182 5TH ST SE
CAIRO, GA
ZIP 39828
Phone: (229) 377-9606
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JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. is an end-stage renal disease (esrd) treatment clinic center in Cairo, GA. JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. NPI is 1962433912. The provider is registered as an organization entity type.
The provider Is Doing Business As Grady County Dialysis Facility.

The provider's business location address is:

1182 5TH ST SE
CAIRO, GA
ZIP 39828-141
Phone: (229) 377-9606
Fax: (229) 377-8804

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 CLIA number assigned to this NPI record is 11D2273250 - other - school nurse office with a certificate type of Certificate of Waiver.

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

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	ESRD001128	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	000710322A	MEDICAID	GEORGIA
2	113504	MEDICARE OSCAR/CERTIFICATION	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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