Provider Demographics
NPI:1083885313
Name:GROVE HILL MEMORIAL HOSPITAL EMER ROOM
Entity Type:Organization
Organization Name:GROVE HILL MEMORIAL HOSPITAL EMER ROOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:N
Authorized Official - Last Name:AVERETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-275-3191
Mailing Address - Street 1:295 S JACKSON ST
Mailing Address - Street 2:P O BOX 935
Mailing Address - City:GROVE HILL
Mailing Address - State:AL
Mailing Address - Zip Code:36451-3231
Mailing Address - Country:US
Mailing Address - Phone:251-275-3191
Mailing Address - Fax:251-275-4281
Practice Address - Street 1:295 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:GROVE HILL
Practice Address - State:AL
Practice Address - Zip Code:36451-3231
Practice Address - Country:US
Practice Address - Phone:251-275-3191
Practice Address - Fax:251-275-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC840OtherEMER ROOM GROUP NUMBER