Organization
SOUTHERN REGIONAL HEALTH SYSTEM, INC
Active
Other names
SOUTHERN REGIONAL MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN R MCLAIN (EXECUTIVE VP & COO)
(770) 991-8000
Entity
Organization
Contact information
Practice address
11 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2615
(770) 991-8000
Mailing address
11 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2615
(770) 991-8000
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
031-442
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000404A
—
GA
Enumeration date
08/10/2005
Last updated
07/25/2013
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