Provider Demographics
NPI:1093994758
Name:ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS INC
Entity Type:Organization
Organization Name:ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS INC
Other - Org Name:ACH FAMILY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-368-6362
Mailing Address - Street 1:611 E LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:ATMORE
Mailing Address - State:AL
Mailing Address - Zip Code:36502-3014
Mailing Address - Country:US
Mailing Address - Phone:251-368-8001
Mailing Address - Fax:251-368-8081
Practice Address - Street 1:611 E LAUREL ST
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-3014
Practice Address - Country:US
Practice Address - Phone:251-368-8001
Practice Address - Fax:251-368-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01-3444OtherPROVIDER BASED RURAL HEALTH
AL510-07377OtherBLUE CROSS AND BLUE SHIELD
AL529932985Medicaid
AL01-3444OtherPROVIDER BASED RURAL HEALTH