# SOUTHERN REGIONAL HEALTH SYSTEM, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SOUTHERN REGIONAL MEDICAL CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831190958
- **Authorized official:** MR. JOHN R MCLAIN (EXECUTIVE VP & COO)
- **Authorized official phone:** (770) 991-8000

## Contact information

- **Practice address:** 11 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2615
- **Practice address phone:** (770) 991-8000
- **Mailing address:** 11 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2615
- **Mailing address phone:** (770) 991-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 031-442 | GA | Yes |

## Other

- **Enumeration date:** 08/10/2005
- **Last updated:** 07/25/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00000404A | — | GA |