SCREVEN COUNTY HOSPITAL LLC (NPI# 1578842712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578842712 |
| Entity Type | Organization |
| Organization Name | SCREVEN COUNTY HOSPITAL LLC |
| Other Organization Name | OPTIM PRIMARY CARE - SCREVEN |
| Practice Address |
213 Mims Rd Sylvania GA 30467-1994 |
| Mailing Address |
210 East Derenne Avenue Savannah GA 31405 |
| Practice Telephone | 9125642779 |
| Practice Fax Number | 9125642174 |
| Mailing Telephone | 9126441626 |
| Mailing Fax Number | 9126445260 |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2020-01-09 |
| Authorized Official Name | TERRY L CRAIG (PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 9126445346 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | GA | Allopathic & Osteopathic Physicians | |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Optim Primary Care - Screven | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770886822 | Screven County Hospital LLC | Internal Medicine | 211 Mims Rd, Sylvania, GA 30467-1994 | 2010-12-13 |
| 1083915524 | Screven County Hospital LLC | Medicare Defined Swing Bed Unit | 215 Mims Rd, Sylvania, GA 30467-1994 | 2010-11-16 |
| 1033428214 | Screven County Hospital LLC | Clinic/Center | 961 E Winthrope Ave, Millen, GA 30442-1839 | 2010-10-05 |
| Street Address |
213 MIMS RD |
| City | SYLVANIA |
| State | GA |
| Zip Code | 30467-1994 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659884237 | Rachel Oglesby Edenfield | Nurse Practitioner | 1235 Edenfield Road, Sylvania, GA 30467 | 2017-11-06 |
| 1841739984 | Under The Shadows Private Home Care | Exclusive Provider Organization | 208 Curtis Street, Sylvania, GA 30467 | 2017-02-22 |
| 1023357324 | Jenkins County Hospital, LLC | Surgery | 102 Rocky Ford Rd, Sylvania, GA 30467 | 2013-02-06 |
| 1205195476 | Aacademy Adult Day &seniorliiving Facilityllc | Custodial Care Facility | 168 Davedeharahara Dr, Sylvania, GA 30467 | 2012-05-09 |
| 1407010689 | Screven County Family Medicine | Family Medicine | 215 Mims Road, Sylvania, GA 30467 | 2008-07-16 |
| 1518127687 | Sherma Peter | Family Medicine | 213 Mims Road, Sylvania, GA 30467 | 2008-06-12 |
| 1508925454 | Mppg, Inc. | Family Medicine | 105 Rocky Ford Road, Sylvania, GA 30467 | 2006-12-06 |
| 1891337572 | Allan Kipngeno | Pharmacist | 305 W Ogeechee St, Sylvania, GA 30467 | 2019-10-14 |
| 1770822066 | Screven County Hospital, LLC | Surgery | 102 Rocky Ford Rd, Sylvania, GA 30467 | 2013-02-06 |
| 1588903884 | Tattnall Hospital Company, LLC | Surgery | 102 Rocky Ford Rd, Sylvania, GA 30467 | 2013-02-06 |
| Find all providers in zip 30467 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| 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.