Provider Demographics
NPI:1528110103
Name:THE HOSPITAL AUTHORITY OF MILLER COUNTY
Entity type:Organization
Organization Name:THE HOSPITAL AUTHORITY OF MILLER COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-758-5954
Mailing Address - Street 1:209 NORTH CUTHBERT ST
Mailing Address - Street 2:PO BOX 7
Mailing Address - City:COLQUITT
Mailing Address - State:GA
Mailing Address - Zip Code:39837
Mailing Address - Country:US
Mailing Address - Phone:229-758-3304
Mailing Address - Fax:229-758-6622
Practice Address - Street 1:208 NORTH CUTHBERT ST
Practice Address - Street 2:
Practice Address - City:COLQUITT
Practice Address - State:GA
Practice Address - Zip Code:39837
Practice Address - Country:US
Practice Address - Phone:229-758-3304
Practice Address - Fax:229-758-6622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA100118261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0000014821Medicaid
GA0000014821Medicaid