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Organization

COFFEE REGIONAL MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONALD C LEWIS JR. (VICE-PRESIDENT/CFO)
(912) 384-1900
Entity
Organization

Contact information

Practice address
523 BOWENS MILL RD SW, DOUGLAS, GA 31533-3930
(912) 384-1900
(912) 389-2112
Mailing address
PO BOX 1287, DOUGLAS, GA 31534-1287
(912) 384-1900
(912) 389-2112

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0003443
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000000448B
GA
Enumeration date
07/28/2010
Last updated
08/16/2010
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