Organization
COLQUITT REGIONAL MEDICAL CENTER
Active
Parent organization
COLQUITT REGIONAL MEDICAL CENTER
Other names
Colquitt Regional Hospice
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLQUITT REGIONAL MEDICAL CENTER
Authorized official
MR. JAMES L MATNEY (PRESIDENT)
(229) 985-3420
Entity
Organization
Contact information
Practice address
2516 5TH AVE SE, MOULTRIE, GA 31788-6207
(229) 985-3420
Mailing address
2516 5TH AVE SE, PO BOX 3548, MOULTRIE, GA 31788-6207
(229) 985-3420
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
035069
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000694152A
—
GA
Enumeration date
05/16/2007
Last updated
04/25/2012
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