Organization
HOSPITAL AUTHORITY OF MITCHELL COUNTY
Active
Other names
The Camilla Pediatric Center
Organization subpart
No
Provider details
NPI number
Authorized official
GREG HEMBREE (SENIOR VP/CFO)
(229) 228-2853
Entity
Organization
Contact information
Practice address
25 PERRY ST, CAMILLA, GA 31730-1852
(229) 336-7472
(229) 336-1661
Mailing address
920 CAIRO RD, THOMASVILLE, GA 31792-4255
(229) 227-5500
(229) 227-5505
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
101120
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000001339G
—
GA
01
—
11D0909917
CLIA
—
Enumeration date
07/04/2006
Last updated
04/25/2019
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