Provider Demographics
NPI:1982873212
Name:CHATUGE REGIONAL HOSPITAL INC
Entity type:Organization
Organization Name:CHATUGE REGIONAL HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SELF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-896-7109
Mailing Address - Street 1:110 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HIAWASSEE
Mailing Address - State:GA
Mailing Address - Zip Code:30546-3408
Mailing Address - Country:US
Mailing Address - Phone:706-896-2222
Mailing Address - Fax:706-896-7872
Practice Address - Street 1:110 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HIAWASSEE
Practice Address - State:GA
Practice Address - Zip Code:30546-3408
Practice Address - Country:US
Practice Address - Phone:706-896-2222
Practice Address - Fax:706-896-7872
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHATUGE REGIONAL HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-20
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
275N00000X
GA139-583282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000001933SMedicaid
NC1161324Medicaid
NC1151324Medicaid
GA11Z324Medicare Oscar/Certification