Organization
ST. MARY'S HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
D. MONTEZO CARTER (PRESIDENT & CEO)
(706) 389-3930
Entity
Organization
Contact information
Practice address
1230 BAXTER ST, ATHENS, GA 30606-3712
(706) 389-2950
Mailing address
1230 BAXTER ST, ATHENS, GA 30606-3712
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
OT003867
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134003A
—
GA
Enumeration date
10/30/2013
Last updated
04/04/2018
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