Provider Demographics
NPI:1053400689
Name:BACON CO. HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:BACON CO. HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-632-8961
Mailing Address - Street 1:3406 WILDWOOD AVE.
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:GA
Mailing Address - Zip Code:31557-5065
Mailing Address - Country:US
Mailing Address - Phone:912-647-2952
Mailing Address - Fax:
Practice Address - Street 1:3406 WILDWOOD AVE.
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:GA
Practice Address - Zip Code:31557-5065
Practice Address - Country:US
Practice Address - Phone:912-647-2952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA113499Medicare ID - Type Unspecified