Provider Demographics
NPI:1720095805
Name:DONALSONVILLE HOSPITAL INC
Entity type:Organization
Organization Name:DONALSONVILLE HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:H
Authorized Official - Last Name:ORRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-524-5217
Mailing Address - Street 1:102 HOSPITAL CIRCLE
Mailing Address - Street 2:DONALSONVILLE HOSPITAL
Mailing Address - City:DONALSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:39845
Mailing Address - Country:US
Mailing Address - Phone:229-524-5217
Mailing Address - Fax:229-524-8217
Practice Address - Street 1:102 HOSPITAL CIRCLE
Practice Address - Street 2:
Practice Address - City:DONALSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:39845
Practice Address - Country:US
Practice Address - Phone:229-524-5217
Practice Address - Fax:229-524-8217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA125318282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00206181AMedicaid
GA1D000206181AOtherMEDICAID PHYSICIANS
GA11U194OtherMEDICARE/SWINGBED
GACB5811OtherPALMETTO MEDICARE PART B
GAHOSP52OtherCAHABA/MEDICARE PART B
GA11U194OtherMEDICARE/SWINGBED