Provider Demographics
NPI:1497071575
Name:J. PAUL JONES HOSPITAL
Entity Type:Organization
Organization Name:J. PAUL JONES HOSPITAL
Other - Org Name:J. PAUL JONES HOSPITAL RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
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:334-682-4224
Mailing Address - Fax:334-682-4138
Practice Address - Street 1:319 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:334-682-4224
Practice Address - Fax:334-682-4138
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J. PAUL JONES HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-14
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01-3452OtherMEDICARE CCN