Basic Information
| Provider Information | |||||||||
| NPI: | 1285075929 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FLINT RIVER COMMUNITY HOSPITAL, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 425 QUADRANGLE DR | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | BOLINGBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604403412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8667274612 | ||||||||
| FaxNumber: | 6304706092 | ||||||||
| Practice Location | |||||||||
| Address1: | 509 SUMTER ST | ||||||||
| Address2: | |||||||||
| City: | MONTEZUMA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310631733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8667274612 | ||||||||
| FaxNumber: | 6304706092 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2013 | ||||||||
| LastUpdateDate: | 07/10/2013 | ||||||||
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| AuthorizedOfficialLastName: | BEKKAM | ||||||||
| AuthorizedOfficialFirstName: | NAVEEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8667274612 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NR1301X | Y | Hospitals | General Acute Care Hospital | Rural |
No ID Information.