Provider Demographics
NPI:1114111838
Name:HEALTHCARE AUTHORITY OF ELBA, INC.
Entity Type:Organization
Organization Name:HEALTHCARE AUTHORITY OF ELBA, INC.
Other - Org Name:ELBA GENERAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRILEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LNHA
Authorized Official - Phone:334-897-2257
Mailing Address - Street 1:987 DRAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:ELBA
Mailing Address - State:AL
Mailing Address - Zip Code:36323-1402
Mailing Address - Country:US
Mailing Address - Phone:334-897-2257
Mailing Address - Fax:334-897-1213
Practice Address - Street 1:987 DRAYTON AVE
Practice Address - Street 2:
Practice Address - City:ELBA
Practice Address - State:AL
Practice Address - Zip Code:36323-1402
Practice Address - Country:US
Practice Address - Phone:334-897-2257
Practice Address - Fax:334-897-1213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALH1601282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALHOS0027EMedicaid