1003996000 NPI number — THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON

Table of content: (NPI 1003996000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003996000 NPI number — THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NORTHEAST ALABAMA REGIONAL MEDICAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003996000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1380
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNISTON
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36202-1380
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-235-5860
Provider Business Mailing Address Fax Number:
256-235-5190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 E 10TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNISTON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36207-4716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-235-5860
Provider Business Practice Location Address Fax Number:
253-235-5190
Provider Enumeration Date:
10/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BASS
Authorized Official First Name:
LOUIS
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
256-235-5646

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 273R00000X , with the licence number: 11773 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 11773 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 16832700 . This is a "US DEPT OF LABOR - INPT" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 75429 . This is a "BLUE CROSS HOME HLTH - OT" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 000107731A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010275806 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 03655214 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 41548 . This is a "BLUE CROSS HOME HLTH - RN" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1762482 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010009 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 374485400 . This is a "US DEPT OF LABOR - OP" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 75428 . This is a "BLUE CROSS HOME HLTH - PT" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: NOR7031A , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 75430 . This is a "BLUE CROSS HOME HLTH - ST" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 5000013 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 10392 . This is a "HEALTHSPRING OF ALABAMA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 913984200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: HOS0078H , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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