# SOUTHERN HEALTH CORP OF ELLIJAY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NORTH GEORGIA MEDICAL CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770774515
- **Authorized official:** MS. DEBBIE SELF CFO (CHEIF FINANCIAL OFFICER)
- **Authorized official phone:** (706) 276-4741

## Contact information

- **Practice address:** 1362 S MAIN ST, ELLIJAY, GA 30540-5410
- **Practice address phone:** (706) 276-4741
- **Practice address fax:** (706) 276-4745
- **Mailing address:** PO BOX 2239, ELLIJAY, GA 30540-0025
- **Mailing address phone:** (706) 276-4741
- **Mailing address fax:** (706) 276-4745

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 061-435 | GA | Yes |

## Other

- **Enumeration date:** 08/07/2007
- **Last updated:** 08/07/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1100205 | — | NC |