Basic Information
Provider Information
NPI: 1598790941
EntityType: 2
ReplacementNPI:  
OrganizationName: SOUTHEAST ALABAMA REGIONAL HEALTHCARE AUTHORITY
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: MEDICAL CENTER BARBOUR SWING BED
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 820 W WASHINGTON ST
Address2:  
City: EUFAULA
State: AL
PostalCode: 360271855
CountryCode: US
TelephoneNumber: 3346887000
FaxNumber: 3346887127
Practice Location
Address1: 820 W WASHINGTON ST
Address2:  
City: EUFAULA
State: AL
PostalCode: 360271855
CountryCode: US
TelephoneNumber: 3346887000
FaxNumber: 3346887127
Other Information
ProviderEnumerationDate: 07/12/2006
LastUpdateDate: 06/26/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: PARSONS
AuthorizedOfficialFirstName: TERRI
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 3346887272
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: HOUSTON COUNTY HEALTH CARE AUTHORITY
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
275N00000X  Y Hospital UnitsMedicare Defined Swing Bed Unit 

No ID Information.


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