Organization
CRISP REGIONAL HOSPITAL, INC
Active
Organization
CRISP REGIONAL HOSPITAL, INC
Active
Other names
Crisp Regional Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN WADE WILDER (AUDITOR)
(229) 276-3100
Entity
Organization
Contact information
Practice address
910 N 5TH ST, CORDELE, GA 31015-3254
(229) 276-3100
(229) 276-3297
Mailing address
910 N 5TH ST, CORDELE, GA 31015-3254
(229) 271-9686
(229) 271-9689
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
040063H
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000784198A
—
GA
Enumeration date
02/23/2006
Last updated
06/12/2009
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