Provider Demographics
NPI:1255672507
Name:PERRY COUNTY HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:PERRY COUNTY HOSPITAL ASSOCIATION
Other - Org Name:PC OUTPATIENT REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-683-9696
Mailing Address - Street 1:PO BOX 149
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:AL
Mailing Address - Zip Code:36756-0149
Mailing Address - Country:US
Mailing Address - Phone:334-683-9696
Mailing Address - Fax:334-683-9995
Practice Address - Street 1:505 E LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AL
Practice Address - Zip Code:36756-2323
Practice Address - Country:US
Practice Address - Phone:334-683-9696
Practice Address - Fax:334-683-9995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy