Provider Demographics
NPI:1477520526
Name:J. PAUL JONES HOSPITAL
Entity Type:Organization
Organization Name:J. PAUL JONES HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-682-4131
Mailing Address - Street 1:317 MCWILLIAMS AVE
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AL
Mailing Address - Zip Code:36726-1610
Mailing Address - Country:US
Mailing Address - Phone:334-682-4131
Mailing Address - Fax:334-682-4131
Practice Address - Street 1:317 MCWILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AL
Practice Address - Zip Code:36726-1610
Practice Address - Country:US
Practice Address - Phone:334-682-4131
Practice Address - Fax:334-682-4131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11879282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01U102OtherMEDICARE SWING BED UNIT
102G705981OtherMEDICARE GROUP PTAN
ALHOS0102HMedicaid
AL010-123OtherBLUE CROSS BLUE SHIELD
AL01U102OtherMEDICARE SWING BED UNIT