Organization
PHOEBE PUTNEY MEMORIAL HOSPITAL, INC.
Active
Other names
Phoebe Family Medical Center - Camilla
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LAGESSE (SR VP PHYSICIAN SERVICES)
(229) 312-4055
Entity
Organization
Contact information
Practice address
48 US HIGHWAY 19 S, CAMILLA, GA 31730-1960
(229) 336-5208
(229) 336-8260
Mailing address
PO BOX 3109, ALBANY, GA 31706-3109
(229) 312-5800
(229) 312-5853
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000001482M
—
GA
01
—
GRP1226
MEDICARE GROUP
GA
Enumeration date
06/19/2007
Last updated
05/30/2014
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