Organization
EAST GEORGIA REGIONAL MEDICAL CENTER, LLC
Active
Other names
East Georgia Regional Medical Center LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
1499 FAIR RD, STATESBORO, GA 30458-1683
(912) 486-1000
Mailing address
PO BOX 405998, ATLANTA, GA 30384-5998
(912) 486-1000
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
016506
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000272A
—
GA
01
—
000913
BLUE CROSS
GA
Enumeration date
05/22/2006
Last updated
04/01/2021
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