Provider Demographics
NPI:1245533132
Name:TY COBB HEALTHCARE SYSTEM, INC
Entity type:Organization
Organization Name:TY COBB HEALTHCARE SYSTEM, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-856-6170
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:461 COOK STREET
Mailing Address - City:ROYSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30662-0247
Mailing Address - Country:US
Mailing Address - Phone:706-245-1200
Mailing Address - Fax:706-245-1848
Practice Address - Street 1:7850 ROYSTON RD
Practice Address - Street 2:
Practice Address - City:CARNESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30521
Practice Address - Country:US
Practice Address - Phone:706-245-1200
Practice Address - Fax:706-245-1848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty