Organization
HOSPITAL AUTHORITY OF RANDOLPH COUNTY
Active
Other names
Randolph Medical Associates Shellman
Organization subpart
No
Provider details
NPI number
Authorized official
KIM GILMAN (CEO)
(229) 209-1242
Entity
Organization
Contact information
Practice address
206 WEST RAILROAD STREET, SHELLMAN, GA 39886-5003
(229) 679-5579
(229) 679-5584
Mailing address
206 WEST RAILROAD STREET, SHELLMAN, GA 39886-5003
(229) 679-5579
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
614225598A
—
GA
Enumeration date
02/10/2006
Last updated
02/22/2016
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