HOSPITAL AUTHORITY OF LIBERTY COUNTY (NPI# 1093214041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093214041 |
| Entity Type | Organization |
| Organization Name | HOSPITAL AUTHORITY OF LIBERTY COUNTY |
| Other Organization Name | LIBERTY REGIONAL MEDICAL ASSOCIATES PRIMARY CARE-MIDWAY CAMPUS |
| Practice Address |
586 Islands Highway Midway GA 31320 |
| Mailing Address |
Po Box 919 Hinesville GA 31314 |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |
| Authorized Official Name | MICHAEL S HESTER (CEO) |
| Authorized Official Telephone | 9123699400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Liberty Regional Medical Associates Primary Care-Midway Campus | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508356395 | Hospital Authority of Liberty County | Obstetrics & Gynecology | 455 S Main St Ste 202, Hinesville, GA 31313-4354 | 2018-05-16 |
| 1023443801 | Hospital Authority of Liberty County | Clinic/Center | 128 Coastal Manor Dr Se, Ludowici, GA 31316-2951 | 2013-09-11 |
| 1013267202 | Hospital Authority of Liberty County | Pediatrics | 455 S.main Street Ste 105, Hinesville, GA 31313 | 2012-09-14 |
| 1356636534 | Hospital Authority of Liberty County | Family Medicine | 455 S.main Street Ste 104, Hinesville, GA 31313 | 2011-06-15 |
| 1477875839 | Hospital Authority of Liberty County | Internal Medicine | 455 S Main Street Suite 102, Hinesville, GA 31313 | 2010-02-25 |
| 1265463004 | Hospital Authority of Liberty County | Skilled Nursing Facility | Hwy 84 East, Ludowici, GA 31316 | 2006-07-06 |
| 1326079260 | Hospital Authority of Liberty County | General Acute Care Hospital | 462 E G Miles Parkway, Hinesville, GA 31313-4000 | 2006-07-06 |
| 1063903011 | Hospital Authority of Liberty County | Clinic/Center | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2018-05-25 |
| 1972028660 | Hospital Authority of Liberty County | General Practice | 73 Coastal Manor Dr, Ludowici, GA 31316 | 2017-08-03 |
| 1740516129 | Hospital Authority of Liberty County | Surgery | 455 S Main St Ste 105, Hinesville, GA 31313-4354 | 2009-10-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HOSPITAL AUTHORITY OF LIBERTY COUNTY | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 |
| Street Address |
586 ISLANDS HIGHWAY |
| City | MIDWAY |
| State | GA |
| Zip Code | 31320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811986003 | Traiana Daciana Pacurar | Internal Medicine | 586 Islands Highway, Midway, GA 31320 | 2005-10-19 |
| 1003391459 | Liberty Orthopaedic Associates | Orthopaedic Surgery | 586 Islands Highway, Midway, GA 31320 | 2018-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407123557 | Woodlands Healthcare & Rehab LLC | Skilled Nursing Facility | 625 Coastal Highway 17 N, Midway, GA 31320 | 2011-11-17 |
| 1467638221 | Trinity Healthcare Recruiting Corp | Contractor | 242 Coastal Hwy Suite 100, Prime Care Medical Bldg, Midway, GA 31320 | 2008-01-11 |
| 1043437502 | Noel C. Luis-smith | Physical Therapist | Us Highway 17 North, Woodlands Health Care LLC, Midway, GA 31320 | 2007-04-19 |
| 1245392224 | Coastal Drug Company LLC | Pharmacy | 204 Butler St, Midway, GA 31320 | 2006-12-15 |
| 1285643320 | Betty Jane Long | Pharmacist | 204 Butler Ave, Midway, GA 31320 | 2006-08-07 |
| 1255302733 | Woodland Health Care LLC | Skilled Nursing Facility | 652 N Coastal Hwy 17, Midway, GA 31320 | 2006-01-31 |
| 1124144068 | Coastal Discount Pharmacy | Durable Medical Equipment & Medical Supplies | 204 Butler St, Midway, GA 31320 | 2007-03-22 |
| 1841304383 | Theron Glenn Fox Jr. | Pharmacist | 204 Butler Ave, Midway, GA 31320 | 2006-08-19 |
| 1598019994 | Jamie L Redding | Behavioral Analyst | 79 Olde Cottage Ln, Midway, GA 31320-2307 | 2012-11-07 |
| 1053713537 | Renee Arnette Charlton Brown | Registered Nurse | 89 Arcadia Dr, Midway, GA 31320-3070 | 2014-09-16 |
| Find all providers in zip 31320 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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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.