Provider Demographics
NPI:1477551554
Name:CLAY COUNTY HEALTHCARE AUTHORITY
Entity Type:Organization
Organization Name:CLAY COUNTY HEALTHCARE AUTHORITY
Other - Org Name:CLAY COUNTY HOSPITAL AND NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-354-2131
Mailing Address - Street 1:83825 HIGHWAY 9 STE C
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36251-7981
Mailing Address - Country:US
Mailing Address - Phone:256-354-2131
Mailing Address - Fax:256-354-1230
Practice Address - Street 1:83825 HWY 9
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:AL
Practice Address - Zip Code:36251-1270
Practice Address - Country:US
Practice Address - Phone:256-354-2131
Practice Address - Fax:256-354-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10486282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL010112OtherBCBS PROVIDER NUMBER
ALHOS0073HMedicaid
ALHOS0073HMedicaid