JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. (NPI# 1356372304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356372304 |
| Entity Type | Organization |
| Organization Name | JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. |
| Other Organization Name | BROOKS COUNTY DIALYSIS FACILITY |
| Practice Address |
101 E Davis St Quitman GA 31643-1407 |
| Mailing Address |
920 Cairo Rd Thomasville GA 31792-4255 |
| Practice Telephone | 2292636340 |
| Practice Fax Number | 2292636330 |
| Mailing Telephone | 2292288800 |
| Mailing Fax Number | 2292288892 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2017-03-08 |
| 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 |
ESRD004044 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000407294A | 05 |
| Other Name | Type Code |
|---|---|
| Brooks 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 |
| 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 |
| 1205867256 | John D. Archbold Memorial Hospital, Inc. | Clinic/Center | 251 Us Highway 19 N, Camilla, GA 31730-1410 | 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 |
101 E DAVIS ST |
| City | QUITMAN |
| State | GA |
| Zip Code | 31643-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538670047 | Total Renal Care Inc | Clinic/Center | 101 E Davis St, Quitman, GA 31643-1407 | 2017-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386168938 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1103 W Screven St, Quitman, GA 31643 | 2017-07-26 |
| 1245774025 | Shacora Travis | Contractor | 1200 Carney Road, Quitman, GA 31643 | 2016-12-13 |
| 1528358306 | Thomas Jackson Barrs | Pharmacist | 1103 West Screven St, Quitman, GA 31643 | 2011-04-13 |
| 1326356767 | Robert Eugene Jennings Jr. | Pharmacist | 510 Old Madison Rd, Quitman, GA 31643 | 2010-09-20 |
| 1275854515 | Marable's Heart-to-heart PCh Inc | Home Health | 83 Church Lane, Marable's Heart-to-heart Personal Care Home Inc., Quitman, GA 31643 | 2010-06-22 |
| 1871718577 | Mcleod-gaston Inc | Community/Behavioral Health | 102 N. Madison St., Quitman, GA 31643 | 2007-04-16 |
| 1598804197 | Debra M Seleska | Nurse Practitioner | 907 North Court Street, Quitman, GA 31643 | 2007-02-06 |
| 1184078537 | Brooks County Hospital | Radiology | 903 N Court St, Quitman, GA 31643 | 2016-04-21 |
| 1639523087 | Brooks County Hospital | Radiology | 903 N Court St, Quitman, GA 31643 | 2016-04-21 |
| 1538513981 | Brooks County Hospital | Radiology | 903 N Court St, Quitman, GA 31643 | 2016-04-21 |
| Find all providers in zip 31643 | ||||
| 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 |
|---|---|---|---|---|
| 1538670047 | Total Renal Care Inc | Clinic/Center | 101 E Davis St, Quitman, GA 31643-1407 | 2017-10-24 |
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| 1174140743 | Home Dialysis Services Norcross LLC | Clinic/Center | 3780 Holcomb Bridge Rd Ste E, Norcross, GA 30092-4877 | 2020-06-30 |
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| 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 | ||||
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| 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.