Provider Demographics
NPI:1134473770
Name:PICKENS COUNTY HEALTH CARE AUTHORITY
Entity Type:Organization
Organization Name:PICKENS COUNTY HEALTH CARE AUTHORITY
Other - Org Name:HOME COMFORT MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:205-367-2442
Mailing Address - Street 1:P. O. BOX 478
Mailing Address - Street 2:96 COURT SQUARE
Mailing Address - City:CARROLLTON
Mailing Address - State:AL
Mailing Address - Zip Code:35447
Mailing Address - Country:US
Mailing Address - Phone:205-367-1234
Mailing Address - Fax:
Practice Address - Street 1:96 COURT SQUARE
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:AL
Practice Address - Zip Code:35447
Practice Address - Country:US
Practice Address - Phone:205-367-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL677332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009603260Medicaid
AL1041640001Medicare NSC