Organization
WELLSTAR SYLVAN GROVE HOSPITAL, INC
Active
Other names
Sylvan Grove Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY J BUZDINSKI (EVP)
(470) 644-0012
Entity
Organization
Contact information
Practice address
1050 MCDONOUGH RD, JACKSON, GA 30233-1524
(770) 775-7861
Mailing address
1800 PARKWAY PL SE STE 500, MARIETTA, GA 30067-8237
(470) 956-4981
(770) 999-2489
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00001856A
—
GA
05
—
00001856S
—
GA
01
—
000444
HUMANA
—
05
—
00211549E
—
GA
05
—
00214607F
—
GA
05
—
00282488B
—
GA
01
—
004378
BCBS OF GEORGIA
—
05
—
00495382D
—
GA
05
—
00715107T
—
GA
05
—
00791062E
—
GA
05
—
00885024B
—
GA
05
—
010492809(TRR)
—
MO
05
—
085001319G
—
GA
01
—
111319B000000
SECTION 1011
—
01
—
152710726
KAISER FOUNDATION HEALTH
—
05
—
1703761
—
LA
01
—
23360
COVENTRY HEALTH CARE GEOR
—
01
—
416159
COVENTRY HEALTH CARE GEOR
—
01
—
973964590
AETNA US HEALTHCARE
—
Enumeration date
07/20/2006
Last updated
10/31/2024
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