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801 W Gordon St Thomaston GA 30286-3426 | |
| (706) 647-8111 | |
| (706) 647-4389 |
| Full Name | |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 801 W Gordon St, Thomaston, Georgia |
| Authorized Official Name and Position | Jeffrey Tarrant (CEO) |
| Authorized Official Contact | 7066478111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1059 Thomaston GA 30286-0027 Ph: (706) 647-8111 | 801 W Gordon St Thomaston GA 30286-3426 Ph: (706) 647-8111 |
| NPI Number | 1659376630 |
|---|---|
| Provider Enumeration Date | 06/16/2005 |
| Last Update Date | 07/17/2020 |
| Certification Date | 07/17/2020 |
| Medicare PECOS PAC ID | 8729075536 |
|---|---|
| Medicare Enrollment ID | O20071221000151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659376630 | NPI | - | NPPES |
| 000001988B | Medicaid | GA | |
| 000450 | Other | GA | BLUE CROSS |
| 000001988A | Medicaid | GA | |
| 000001988S | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 145-415 (Georgia) | Secondary |
| 282N00000X | General Acute Care Hospital | 145 415 (Georgia) | Primary |
S&y Personal Care Home Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 W Main St, Thomaston, GA 30286 Phone: 706-647-9389 Fax: 706-647-9389 | |
Moving Spirit Foundation Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 113b E County Rd, Thomaston, GA 30286 Phone: 706-938-8008 |