# MACON COUNTY COMMUNITY HOSPITAL, INC.

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

## Provider details

- **NPI number:** 1922318922
- **Authorized official:** MR. PHILIP EASTMAN III (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (478) 472-3100

## Contact information

- **Practice address:** 509 SUMTER ST, MONTEZUMA, GA 31063-1733
- **Practice address phone:** (478) 472-3100
- **Practice address fax:** (478) 472-2412
- **Mailing address:** 509 SUMTER ST, MONTEZUMA, GA 31063-1733
- **Mailing address phone:** (478) 472-3100
- **Mailing address fax:** (478) 472-2412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 094-391 | GA | Yes |

## Other

- **Enumeration date:** 10/12/2010
- **Last updated:** 10/13/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000149487A | — | GA |