Provider Demographics
NPI:1346773272
Name:SOUTHEAST ALABAMA REGIONAL HEALTHCARE AUTHORITY
Entity Type:Organization
Organization Name:SOUTHEAST ALABAMA REGIONAL HEALTHCARE AUTHORITY
Other - Org Name:MCB GENERAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:N
Authorized Official - Last Name:DREW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-232-4313
Mailing Address - Street 1:825 W WASHINGTON ST STE 5
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-1851
Mailing Address - Country:US
Mailing Address - Phone:334-688-7000
Mailing Address - Fax:
Practice Address - Street 1:825 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-1847
Practice Address - Country:US
Practice Address - Phone:334-688-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHEAST ALABAMA REGIONAL HEALTHCARE AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty