1356692297 NPI number — H H HEALTH SYSTEM-MORGAN LLC

Table of content: (NPI 1356692297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356692297 NPI number — H H HEALTH SYSTEM-MORGAN LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
H H HEALTH SYSTEM-MORGAN LLC
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:
DECATUR MORGAN HOSPITAL-DECATUR CAMPUS
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:
1356692297
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11407
Provider Second Line Business Mailing Address:
DEPT # 5531
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35246-5531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-341-2010
Provider Business Mailing Address Fax Number:
256-306-1691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 7TH ST SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DECATUR
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35601-3337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-341-2010
Provider Business Practice Location Address Fax Number:
256-306-1691
Provider Enumeration Date:
10/01/2012

Additional Information

Authorized Official

Authorized Official Last Name:
BONETTI
Authorized Official First Name:
VINCENT
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR, REVENUE CYCLE
Authorized Official Telephone Number:
256-265-9641

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  H5202 , 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: 558200840 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 235280000 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 012 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 086 . This is a "BLUE CROSS OF ALABAMA-DGW" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: HOS0085H , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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