Provider Demographics
NPI:1437377793
Name:BIBB COUNTY HOSPITAL BOARD
Entity Type:Organization
Organization Name:BIBB COUNTY HOSPITAL BOARD
Other - Org Name:BIBB MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-926-4881
Mailing Address - Street 1:208 PIERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35042-2918
Mailing Address - Country:US
Mailing Address - Phone:205-926-4881
Mailing Address - Fax:205-926-5866
Practice Address - Street 1:208 PIERSON AVE
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:AL
Practice Address - Zip Code:35042-2918
Practice Address - Country:US
Practice Address - Phone:205-926-4881
Practice Address - Fax:205-926-5866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4790580SMedicaid