JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. (NPI# 1205867256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205867256 |
| Entity Type | Organization |
| Organization Name | JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. |
| Other Organization Name | MITCHELL COUNTY DIALYSIS FACILITY |
| Practice Address |
251 Us Highway 19 N Camilla GA 31730-1410 |
| Mailing Address |
920 Cairo Rd Thomasville GA 31792-4255 |
| Practice Telephone | 2293365874 |
| Practice Fax Number | 2293365878 |
| Mailing Telephone | 2292288800 |
| Mailing Fax Number | 2292288892 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2017-03-03 |
| Authorized Official Name | MR. GREGORY S. HEMBREE (CFO) |
| Authorized Official Telephone | 2292282880 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
ESRD001132 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000407327A | 05 |
| Other Name | Type Code |
|---|---|
| Mitchell County Dialysis Facility | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972635233 | John D. Archbold Memorial Hospital, Inc. | Clinic/Center | 1323 E Shotwell St, Bainbridge, GA 39819-4252 | 2007-03-12 |
| 1932296811 | John D. Archbold Memorial Hospital, Inc. | Clinic/Center | 1103 North Main Street, Pavo, GA 31778 | 2006-10-10 |
| 1114014669 | John D. Archbold Memorial Hospital, Inc. | Clinic/Center | 1034 South Pine Street, Coolidge, GA 31738 | 2006-10-06 |
| 1851486005 | John D. Archbold Memorial Hospital, Inc. | Clinic/Center | 440 Smith Ave, Thomasville, GA 31792-5535 | 2006-10-04 |
| 1356372304 | John D. Archbold Memorial Hospital, Inc. | Clinic/Center | 101 E Davis St, Quitman, GA 31643-1407 | 2006-07-06 |
| 1962433912 | John D. Archbold Memorial Hospital, Inc. | Clinic/Center | 1182 5th St Se, Cairo, GA 39828-3141 | 2006-07-06 |
| 1609807650 | John D. Archbold Memorial Hospital, Inc. | Clinic/Center | 700 Gordon Ave, Bainbridge, GA 39819-5713 | 2006-07-06 |
| 1629000328 | John D. Archbold Memorial Hospital, Inc. | Clinic/Center | 201 Old Albany Rd, Thomasville, GA 31792-4010 | 2006-07-06 |
| 1730123431 | John D. Archbold Memorial Hospital, Inc. | Psychiatric Unit | 401 Old Albany Rd, Thomasville, GA 31792-4014 | 2006-06-15 |
| 1508806142 | John D. Archbold Memorial Hospital, Inc. | Skilled Nursing Facility | 10629 Us Highway 19 S, Thomasville, GA 31792-1127 | 2006-06-08 |
| Street Address |
251 US HIGHWAY 19 N |
| City | CAMILLA |
| State | GA |
| Zip Code | 31730-1410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902317407 | Total Renal Care Inc | Clinic/Center | 251 Us Highway 19 N, Camilla, GA 31730-1410 | 2017-10-24 |
| 1184830838 | Shenika Laverne Jackson | Occupational Therapist | 251 Us Highway 19 N, Camilla, GA 31730-1410 | 2007-05-16 |
| 1932314523 | Robin Lyn Thomas | Physical Therapist | 251 Us Highway 19 N, Camilla, GA 31730-1410 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700310059 | Phoebe Primary Care of Camilla | Clinic/Center | 725 Us Highway 19 S, Camilla, GA 31730 | 2017-04-13 |
| 1134661028 | Montreal Biggins Sr. | Counselor | 198 South Mcarthur Drive, Camilla, GA 31730 | 2016-11-09 |
| 1447639307 | Ledora Inman | Counselor | 198 S. Mac Arthur Drive, Camila, GA 31730 | 2015-05-26 |
| 1336533652 | Southern Therapeutic Massage Studio LLC | Massage Therapist | 88 W. Broad St, Camilla, GA 31730 | 2015-03-25 |
| 1013306604 | Jamekah Brooks | Counselor | 198 S Macarthur Drive, Camilla, GA 31730 | 2015-01-20 |
| 1063811651 | Develle Miller | Counselor | 198 S. Macarthur, Camilla, GA 31730 | 2014-08-19 |
| 1679980247 | Amanda Bryant | Counselor | 198 S. Macarthur Dr., Camilla, GA 31730 | 2014-07-16 |
| 1578993945 | Ted Hall | Counselor | 218 S. Mcarthur Drive, Camilla, GA 31730 | 2013-11-20 |
| 1700216280 | Michael D Fowler I | Case Management | 198 S. Macarthur Drive, Camilla, GA 31730 | 2013-11-19 |
| 1750644753 | Sally Niazi | Pharmacist | 266 E Broad Street, Camilla, GA 31730 | 2012-06-25 |
| Find all providers in zip 31730 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902317407 | Total Renal Care Inc | Clinic/Center | 251 Us Highway 19 N, Camilla, GA 31730-1410 | 2017-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871190207 | Usrc Powder Springs Home LLC | Clinic/Center | 3721 New Macland Rd Ste 100b, Powder Springs, GA 30127-2000 | 2020-10-08 |
| 1083229280 | Bio- Medical Applications of Georgia, Inc. | Clinic/Center | 145 W Hendry St, Hinesville, GA 31313-3201 | 2020-09-14 |
| 1336759463 | Plattaz Dialysis, LLC | Clinic/Center | 100 Promenade Pkwy Ste C, Fayetteville, GA 30214-7735 | 2020-08-04 |
| 1174140743 | Home Dialysis Services Norcross LLC | Clinic/Center | 3780 Holcomb Bridge Rd Ste E, Norcross, GA 30092-4877 | 2020-06-30 |
| 1265058275 | Dialysis Care Center Pleasant Hill LLC | Clinic/Center | 1425 Georgia Ave Ste 102, Macon, GA 31201-6546 | 2020-06-25 |
| 1598389132 | Concerto Georgia LLC | Clinic/Center | 655 Exchange Cir Ste 100, Bethlehem, GA 30620-1767 | 2020-05-29 |
| 1629607098 | Rutledge Dialysis, LLC | Clinic/Center | 1719 New Hope Rd, Lawrenceville, GA 30045-6570 | 2020-04-07 |
| 1215562293 | Dialysis Clinic Inc | Clinic/Center | 1219 S. Martin Luther King Blvd., Americuse, GA 31719 | 2020-03-10 |
| 1659915882 | Filmore Dialysis, LLC | Clinic/Center | 4555 Atlanta Hwy Ste M, Loganville, GA 30052-2646 | 2019-10-31 |
| 1013562818 | Menca Dialysis, LLC | Clinic/Center | 3030 Headland Dr Sw Ste C, Atlanta, GA 30311-5435 | 2019-08-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.