Organization · NPI-2
Tift Regional Health System INC
Clinic/Center · Tifton, GA
NPI number1003980996
StatusActive
Last updated in NPPESNov 21, 2023
Details
- NPI
- 1003980996
- Entity type
- Organization (NPI-2)
- Legal business name
- Tift Regional Health System INC
- Organization subpart
- No
- Enumeration date
- Nov 20, 2006
- Certification date
- Nov 21, 2023
- Last updated
- Nov 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | 137-180 | GA | Yes |
Other names
- Worksmart Occupational Medicine (Doing Business As)
Practice location
4468 Union RdTifton, GA 31794-8331
Phone 229-353-6320 · Fax 229-353-6343
Mailing address
4468 Union RdTifton, GA 31794-8331
Phone 229-353-6320 · Fax 229-353-6343
Authorized official
Kristy Gladden
Provider Enrollment Manager
2293533402
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