Provider Demographics
NPI:1326288770
Name:DECATUR GENERAL HOSPITAL
Entity Type:Organization
Organization Name:DECATUR GENERAL HOSPITAL
Other - Org Name:THE HEALTHCARE AUTHORITY OF MORGAN COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXE DIR, REVENUE CYC
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BONETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-265-9641
Mailing Address - Street 1:PO BOX 2239
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35609-2239
Mailing Address - Country:US
Mailing Address - Phone:256-341-2000
Mailing Address - Fax:256-306-1691
Practice Address - Street 1:2205 BELTLINE RD SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3617
Practice Address - Country:US
Practice Address - Phone:256-341-2010
Practice Address - Fax:256-306-1691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11859273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL010-824OtherBLUE CROSS
ALHOS0085HMedicaid
AL01S085Medicare Oscar/Certification
AL010-824OtherBLUE CROSS