Provider Demographics
NPI:1063720415
Name:LOWER OCONEE COMMUNITY HOSPITAL, INC.
Entity type:Organization
Organization Name:LOWER OCONEE COMMUNITY HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PEYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-523-5113
Mailing Address - Street 1:P. O. BOX 398
Mailing Address - Street 2:111 NORTH 3RD STREET
Mailing Address - City:GLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30428
Mailing Address - Country:US
Mailing Address - Phone:912-523-5113
Mailing Address - Fax:912-523-2049
Practice Address - Street 1:111 NORTH 3RD STREET
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30428
Practice Address - Country:US
Practice Address - Phone:912-523-5113
Practice Address - Fax:912-523-2049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health