Organization
NW GA REGIONAL HOSPITAL
Active
Parent organization
STATE OF GEORGIA DEPARTMENT OF HUMAN RESOURCES
Other names
Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF GEORGIA DEPARTMENT OF HUMAN RESOURCES
Authorized official
TAMMY VAUGHN (PATIENT ACCOUNTS OFFICER)
(706) 295-6298
Entity
Organization
Contact information
Practice address
705 N DIVISION ST NW, ROME, GA 30165-1454
(706) 295-6298
Mailing address
705 N DIVISION ST NW, PATIENT ACCOUNTS OFFICE, ROME, GA 30165-1454
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000355748A
—
GA
01
—
114014
MEDICARE PROVIDER NUMBER
GA
Enumeration date
04/09/2007
Last updated
06/23/2009
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