Organization
HOSPITAL AUTHORITY OF THE CITY OF BAINBRIDGE AND DECATUR COUNTY
Active
Other names
Memorial Hospital and Manor
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN FAIRCLOTH (CFO)
(229) 246-8211
Entity
Organization
Contact information
Practice address
1500 E SHOTWELL ST, BAINBRIDGE, GA 39819-4256
(229) 246-3500
(229) 246-8142
Mailing address
1500 E SHOTWELL ST, BAINBRIDGE, GA 39819-4256
(229) 246-3500
(229) 246-8142
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
275N00000X
Medicare Defined Swing Bed Hospital Unit
—
—
282N00000X
General Acute Care Hospital
43-112
GA
314000000X
Skilled Nursing Facility
1-043-500
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00001262A
—
GA
05
—
00001262S
—
GA
05
—
00001262T
—
GA
01
—
000307
BLUE CROSS BLUE SHIELD
GA
05
—
00141919A
—
GA
Enumeration date
03/07/2006
Last updated
01/27/2022
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