Provider Demographics
NPI:1902468085
Name:THOMASVILLE REGIONAL MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:THOMASVILLE REGIONAL MEDICAL CENTER, LLC
Other - Org Name:THOMASVILLE REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MSHA, FACHE
Authorized Official - Phone:334-456-6450
Mailing Address - Street 1:1200 CORPORATE DR # 470
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2941
Mailing Address - Country:US
Mailing Address - Phone:205-451-7839
Mailing Address - Fax:
Practice Address - Street 1:300 MED PARK DR
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:AL
Practice Address - Zip Code:36784-5760
Practice Address - Country:US
Practice Address - Phone:205-873-1442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-28
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital