Organization
CHARLTON MEMORIAL HOSPITAL
Active
Parent organization
CHARLTON MEMORIAL HOSPITAL
Other names
Family Practice Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHARLTON MEMORIAL HOSPITAL
Authorized official
MS. FATIMA MCCASLAND (CLINIC DIRECTOR)
(912) 496-2697
Entity
Organization
Contact information
Practice address
2383 THIRD ST, FOLKSTON, GA 31537-8917
(912) 496-2697
(912) 496-1139
Mailing address
2383 THIRD ST, FOLKSTON, GA 31537-8917
(912) 496-2697
(912) 496-1139
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164482236A
—
GA
05
—
814096430A
—
GA
01
—
HOSP45
MEDICARE PART B PTAN
GA
Enumeration date
12/29/2006
Last updated
07/26/2012
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