Provider Demographics
NPI:1275713612
Name:YORK HEALTH CLINIC
Entity Type:Organization
Organization Name:YORK HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:2053-925-2263
Mailing Address - Street 1:723 DERBY DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:AL
Mailing Address - Zip Code:36925-2121
Mailing Address - Country:US
Mailing Address - Phone:205-392-7477
Mailing Address - Fax:205-392-7379
Practice Address - Street 1:723 DERBY DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:AL
Practice Address - Zip Code:36925-2121
Practice Address - Country:US
Practice Address - Phone:205-392-7477
Practice Address - Fax:205-392-7379
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HILL HOSPITAL OF SUMTER COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALAPPLIED FOROtherAPPLIED FOR