# WILDWOOD SANITARIUM INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wildwood Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902957541
- **Authorized official:** MR. VAUGHAN HARVEY SPARROW (HOSPITAL ADMINISTRATOR)
- **Authorized official phone:** (706) 820-1493

## Contact information

- **Practice address:** 435 LIFESTYLE LANE, WILDWOOD, GA 30757-0129
- **Practice address phone:** (706) 820-1493
- **Mailing address:** P.O BOX 129, WILDWOOD, GA 30757-0129
- **Mailing address phone:** (706) 820-1493
- **Mailing address fax:** (706) 820-7459

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 41198 | GA | Yes |

## Other

- **Enumeration date:** 01/12/2007
- **Last updated:** 08/12/2010