Provider Demographics
NPI:1902946908
Name:GEORGIA CHRISTIAN MEDICAL, LLC
Entity Type:Organization
Organization Name:GEORGIA CHRISTIAN MEDICAL, LLC
Other - Org Name:HOPE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-798-5645
Mailing Address - Street 1:2604 PEACH ORCHARD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-2406
Mailing Address - Country:US
Mailing Address - Phone:706-798-5645
Mailing Address - Fax:706-798-0377
Practice Address - Street 1:2604 PEACH ORCHARD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-2406
Practice Address - Country:US
Practice Address - Phone:706-798-5645
Practice Address - Fax:706-798-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty