Basic Information
| Provider Information | |||||||||
| NPI: | 1770732968 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITAL AUTHORITY OF EFFINGHAM COUNTY | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | EFFINGHAM IMAGING CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 GOSHEN ROAD | ||||||||
| Address2: | |||||||||
| City: | RINCON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9127546451 | ||||||||
| FaxNumber: | 9127549901 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 GOSHEN ROAD | ||||||||
| Address2: | |||||||||
| City: | RINCON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9128261400 | ||||||||
| FaxNumber: | 9128261490 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2008 | ||||||||
| LastUpdateDate: | 09/12/2008 | ||||||||
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| AuthorizedOfficialLastName: | MORGAN | ||||||||
| AuthorizedOfficialFirstName: | NORMA | ||||||||
| AuthorizedOfficialMiddleName: | JEAN | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9127546451 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Magnetic Resonance Imaging (MRI) |
No ID Information.