Organization · NPI-2
Tift Regional Health System INC
Clinic/Center · Tifton, GA
NPI number1306244090
StatusActive
Last updated in NPPESJun 24, 2022
Details
- NPI
- 1306244090
- Entity type
- Organization (NPI-2)
- Legal business name
- Tift Regional Health System INC
- Organization subpart
- No
- Enumeration date
- Dec 11, 2014
- Certification date
- Jun 24, 2022
- Last updated
- Jun 24, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | 031888 | GA | Yes |
Other names
- Tift Regional Wound Care Center (Doing Business As)
Practice location
907 18th St ESuite 140
Tifton, GA 31794-3643
Phone 229-353-4325
Mailing address
Po Box 2650Tifton, GA 31793-2650
Phone 229-353-3422
Authorized official
Christopher Dorman
President/Ceo
2293536104
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