Provider Demographics
NPI:1003996000
Name:THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON
Entity Type:Organization
Organization Name:THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON
Other - Org Name:NORTHEAST ALABAMA REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-235-5646
Mailing Address - Street 1:PO BOX 1380
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-1380
Mailing Address - Country:US
Mailing Address - Phone:256-235-5860
Mailing Address - Fax:256-235-5190
Practice Address - Street 1:400 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4716
Practice Address - Country:US
Practice Address - Phone:256-235-5860
Practice Address - Fax:253-235-5190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
AL11773273R00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No251E00000XAgenciesHome Health
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL16832700OtherUS DEPT OF LABOR - INPT
AL75429OtherBLUE CROSS HOME HLTH - OT
GA000107731AMedicaid
VA010275806Medicaid
MS03655214Medicaid
AL41548OtherBLUE CROSS HOME HLTH - RN
LA1762482Medicaid
AL010009OtherBLUE CROSS
AL374485400OtherUS DEPT OF LABOR - OP
AL75428OtherBLUE CROSS HOME HLTH - PT
ALNOR7031AMedicaid
AL75430OtherBLUE CROSS HOME HLTH - ST
AL5000013OtherUNITED HEALTHCARE
AL10392OtherHEALTHSPRING OF ALABAMA
FL913984200Medicaid
ALHOS0078HMedicaid
ALHOS0078HMedicaid
FL913984200Medicaid
AL16832700OtherUS DEPT OF LABOR - INPT
AL010078Medicare Oscar/Certification