Provider Demographics
NPI:1316128325
Name:THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY
Entity type:Organization
Organization Name:THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:PEEK
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-367-9841
Mailing Address - Street 1:PO BOX 2070
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31515-2070
Mailing Address - Country:US
Mailing Address - Phone:912-367-9841
Mailing Address - Fax:912-367-1272
Practice Address - Street 1:163 E TOLLISON ST
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-0120
Practice Address - Country:US
Practice Address - Phone:912-367-9841
Practice Address - Fax:912-367-1272
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APPLING HEALTHCARE SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-19
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00140093AMedicaid
GA115262Medicare Oscar/Certification