Organization
MACON COUNTY COMMUNITY HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP EASTMAN III (CHIEF EXECUTIVE OFFICER)
(478) 472-3100
Entity
Organization
Contact information
Practice address
509 SUMTER ST, MONTEZUMA, GA 31063-1733
(478) 472-3100
(478) 472-2412
Mailing address
509 SUMTER ST, MONTEZUMA, GA 31063-1733
(478) 472-3100
(478) 472-2412
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
094-391
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000149487A
—
GA
Enumeration date
10/12/2010
Last updated
10/13/2010
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