# ST. MARY'S HEALTHCARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881022804
- **Authorized official:** D. MONTEZO CARTER (PRESIDENT & CEO)
- **Authorized official phone:** (706) 389-3930

## Contact information

- **Practice address:** 1230 BAXTER ST, ATHENS, GA 30606-3712
- **Practice address phone:** (706) 389-2950
- **Mailing address:** 1230 BAXTER ST, ATHENS, GA 30606-3712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | OT003867 | GA | Yes |

## Other

- **Enumeration date:** 10/30/2013
- **Last updated:** 04/04/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003134003A | — | GA |