Organization
FANNIN REGIONAL HOSPITAL INC
Active
Parent organization
FANNIN REGIONAL HOSPITAL INC
Other names
Tri County Diagnostic Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
FANNIN REGIONAL HOSPITAL INC
Authorized official
LAURIE HOLTSFORD (SENIOR VP, GROUP OPERATIONS)
(615) 465-7466
Entity
Organization
Contact information
Practice address
772 MADDOX DR, STE 126, EAST ELLIJAY, GA 30540-8194
(706) 273-2105
Mailing address
PO BOX 198161, ATLANTA, GA 30384-8161
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
GA
261QR0200X
Radiology Clinic/Center
Primary
055-452
GA
Other
Enumeration date
03/10/2006
Last updated
08/20/2008
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