Organization
HOSPITAL AUTHORITY OF MITCHELL COUNTY
Active
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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