Organization
HOSPITAL AUTHORITY OF WASHINGTON COUNTY
Active
Parent organization
HOSPITAL AUTHORITY OF WASHINGTON COUNTY
Other names
Washington County Therapy Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOSPITAL AUTHORITY OF WASHINGTON COUNTY
Authorized official
OWEN TYRELL KELLY (PROVIDER ENROLLMENT COORDINATOR)
(478) 289-1192
Entity
Organization
Contact information
Practice address
610 SPARTA RD, SANDERSVILLE, GA 31082-1860
(478) 240-2000
Mailing address
610 SPARTA RD, SANDERSVILLE, GA 31082-1860
(478) 240-2000
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000001218A
—
GA
Enumeration date
09/23/2019
Last updated
06/03/2020
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