Provider Demographics
NPI:1972978948
Name:TATTNALL HOSPITAL COMPANY, LLC
Entity type:Organization
Organization Name:TATTNALL HOSPITAL COMPANY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY OF TATTNALL HOSPTIAL COMP
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUENTHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-627-8247
Mailing Address - Street 1:210 E DERENNE AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6736
Mailing Address - Country:US
Mailing Address - Phone:912-644-1626
Mailing Address - Fax:912-644-5260
Practice Address - Street 1:109 S DUVAL ST
Practice Address - Street 2:
Practice Address - City:CLAXTON
Practice Address - State:GA
Practice Address - Zip Code:30417-2029
Practice Address - Country:US
Practice Address - Phone:912-557-1000
Practice Address - Fax:912-557-1009
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TATTNALL HOSPITAL COMPANY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty