Provider Demographics
NPI:1508440488
Name:GENEVA COUNTY HEALTHCARE AUTHORITY, INC.
Entity Type:Organization
Organization Name:GENEVA COUNTY HEALTHCARE AUTHORITY, INC.
Other - Org Name:SAMSON RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-684-3655
Mailing Address - Street 1:1200 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:AL
Mailing Address - Zip Code:36340-1642
Mailing Address - Country:US
Mailing Address - Phone:334-684-3655
Mailing Address - Fax:334-684-0299
Practice Address - Street 1:98 E MORRIS ST
Practice Address - Street 2:
Practice Address - City:SAMSON
Practice Address - State:AL
Practice Address - Zip Code:36477-1229
Practice Address - Country:US
Practice Address - Phone:334-898-2728
Practice Address - Fax:334-898-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health