Organization
GEORGIA DEPARTMENT OF HUMAN RESOURCES
Active
Other names
East Central Regional Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYDIA WEISSER M.D. (CLINICAL DIRECTOR)
(706) 792-7021
Entity
Organization
Contact information
Practice address
3405 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 792-7021
Mailing address
3405 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 792-7021
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHH004147
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355737A
—
GA
Enumeration date
12/14/2006
Last updated
08/22/2020
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