Organization
COLQUITT REGIONAL MEDICAL CENTER
Active
Parent organization
COLQUITT REGIONAL MEDICAL CENTER
Other names
Colquitt Regional Medical Center Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLQUITT REGIONAL MEDICAL CENTER
Authorized official
MR. JIM MATNEY (PRESIDENT/CEO)
(229) 985-3420
Entity
Organization
Contact information
Practice address
15 HOSPITAL PARK, MOULTRIE, GA 31768-6772
(229) 891-9333
Mailing address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 985-3420
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
035296
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000408845A
—
GA
Enumeration date
02/28/2007
Last updated
05/30/2025
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