Provider Demographics
NPI:1225682537
Name:TOMBIGBEE HEALTHCARE AUTHORITY
Entity Type:Organization
Organization Name:TOMBIGBEE HEALTHCARE AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-287-2529
Mailing Address - Street 1:1007 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:AL
Mailing Address - Zip Code:36748-3149
Mailing Address - Country:US
Mailing Address - Phone:334-289-4000
Mailing Address - Fax:334-287-2594
Practice Address - Street 1:1007 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:AL
Practice Address - Zip Code:36748-3149
Practice Address - Country:US
Practice Address - Phone:334-289-4000
Practice Address - Fax:334-287-2594
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOMBIGBEE HEALTHCARE AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health