BACCHUS OPERATIONS GROUP, INC. (NPI# 1518026202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518026202 |
| Entity Type | Organization |
| Organization Name | BACCHUS OPERATIONS GROUP, INC. |
| Other Organization Name | FLINT RIVER RURAL HEALTH CLINIC - ELLAVILLE |
| Practice Address |
509 Sumter Street Montezuma GA 31063-1733 |
| Mailing Address |
509 Sumter Street Po Box 770 Montezuma GA 31063-1733 |
| Practice Telephone | 4784723100 |
| Practice Fax Number | 4784722412 |
| Mailing Telephone | 4784723100 |
| Mailing Fax Number | 4784722412 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2012-03-23 |
| Authorized Official Name | MR. PHILIP H EASTMAN III (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 4784723100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
094-391 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000149487B | 05 |
| Other Name | Type Code |
|---|---|
| Flint River Rural Health Clinic - Ellaville | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922168400 | Bacchus Operations Group, Inc. | Medicare Defined Swing Bed Unit | 509 Sumter St, Montezuma, GA 31063-1733 | 2006-12-12 |
| 1104914480 | Bacchus Operations Group, Inc. | Clinic/Center | 502 Sumter St, Montezuma, GA 31063-1734 | 2006-10-11 |
| 1033204987 | Bacchus Operations Group, Inc. | General Acute Care Hospital | 509 Sumter St, Montezuma, GA 31063-1733 | 2006-10-04 |
| Street Address |
509 SUMTER STREET |
| City | MONTEZUMA |
| State | GA |
| Zip Code | 31063-1733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184240939 | Elizabeth Cupp Greene | Nurse Practitioner | 506c Spaulding Road, Suite B, Montezuma, GA 31063 | 2020-06-17 |
| 1013308311 | Margo Renee Gaskins | Nurse Practitioner | 506 C Spaulding Rd, Suite B, Montezuma, GA 31063 | 2015-02-09 |
| 1407252638 | Careconnect Health, Inc. | Clinic/Center | 506-c Spaulding Road, Suite B, Montezuma, GA 31063 | 2014-11-17 |
| 1861802134 | Freds Stores of Tennessee Inc | Pharmacy | 201 Walnut Street, Montezuma, GA 31063 | 2014-05-07 |
| 1588093637 | Premier Healthcare Investments | Medicare Defined Swing Bed Unit | 509 Sumter, Montezuma, GA 31063 | 2013-11-08 |
| 1194873661 | Charlene Marie Hanson | Nurse Practitioner | Flint River Hospital, 509 Sumpter Street, Montezuma, GA 31063 | 2007-01-08 |
| 1235201138 | John D Hames | Pharmacist | 112 S Dooly St, Montezuma, GA 31063 | 2006-11-15 |
| 1093888687 | Quincy Jerome Jordan Sr. | Family Medicine | 509 Sumter St, Montezuma, GA 31063 | 2006-11-15 |
| 1073129896 | Lotus Nest Counseling Services LLC | Marriage & Family Therapist | 906 Weathers Dr, Montezuma, GA 31063-1016 | 2020-09-17 |
| 1609408319 | Lucille Brown | Social Worker | 902 June Dr, Montezuma, GA 31063-1021 | 2020-02-10 |
| Find all providers in zip 31063 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720609738 | Meade Hospital District | Clinic/Center | 304 N Aztec St, Montezuma, KS 67867-8874 | 2020-04-30 |
| 1659700763 | Premier Healthcare Investments | Clinic/Center | 502 Sumter St, Montezuma, GA 31063-1734 | 2013-11-08 |
| 1285961250 | Macon County Medical Center, Inc Dba Flint River Community Hospital | Clinic/Center | 502 Sumter St, Montezuma, GA 31063-1733 | 2009-11-11 |
| 1104914480 | Bacchus Operations Group, Inc. | Clinic/Center | 502 Sumter St, Montezuma, GA 31063-1734 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437651924 | Amanda Mckenzie | Clinic/Center | Us Renal Care 657 Hemlock Street, Macon, GA 31206 | 2018-03-01 |
| 1518398049 | Norman Park Family Medicine Clinic | Clinic/Center | 139 East Broad Street, Norman Park, GA 31771 | 2013-12-10 |
| 1992147573 | Doerun Family Medicine Clinic | Clinic/Center | 128 West Broad Ave, Doerun, GA 31744 | 2013-07-23 |
| 1366784415 | Emanuel County Hospital Authority | Clinic/Center | 131a Victory Dr, Swainsboro, GA 30401-3234 | 2013-03-26 |
| 1306114004 | Lower Oconee Community Hospital, Inc | Clinic/Center | 421 W Robinson Dr, Mount Vernon, GA 30445-2935 | 2011-12-08 |
| 1013248962 | Southern Health Corp of Ellijay | Clinic/Center | 60 Old Highway 5 South, Ellijay, GA 30540-5436 | 2010-01-15 |
| 1427384353 | Union County Hospital Authority | Clinic/Center | 103 Church St Ste A, Hiawassee, GA 30546-3223 | 2009-10-28 |
| 1346574084 | Durall Capital Holdings, LLC | Clinic/Center | 59 Tipton Drive, Dahlonega, GA 30533 | 2009-09-29 |
| 1215260617 | Durall Capital Holdings, LLC | Clinic/Center | 35 Lumpkin Campground Road N, Dawsonville, GA 30534 | 2009-09-16 |
| 1376778001 | Phoebe Sumter Medical Center, Inc | Clinic/Center | 339 S Broad St, Ellaville, GA 31806-3304 | 2009-05-26 |
| 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.