Provider Demographics
NPI:1396037230
Name:THE DCH HEALTH CARE AUTHORITY
Entity Type:Organization
Organization Name:THE DCH HEALTH CARE AUTHORITY
Other - Org Name:DCH HEALTH CARE AUTHORITY - REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER AGENT
Authorized Official - Prefix:
Authorized Official - First Name:KERI
Authorized Official - Middle Name:H
Authorized Official - Last Name:HINDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-759-7378
Mailing Address - Street 1:809 UNIVERSITY BLVD E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2029
Mailing Address - Country:US
Mailing Address - Phone:205-343-8500
Mailing Address - Fax:205-759-6397
Practice Address - Street 1:2700 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-3360
Practice Address - Country:US
Practice Address - Phone:205-333-4330
Practice Address - Fax:205-759-6397
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DCH HEALTHCARE AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-11
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL06972273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01T092Medicare Oscar/Certification