Provider Demographics
NPI:1588615033
Name:THE HEALTH CARE AUTHORITY OF THE CITY OF HUNTSVILLE
Entity Type:Organization
Organization Name:THE HEALTH CARE AUTHORITY OF THE CITY OF HUNTSVILLE
Other - Org Name:HUNTSVILLE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR, PFS
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BONETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-265-9641
Mailing Address - Street 1:101 SIVLEY RD SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4421
Mailing Address - Country:US
Mailing Address - Phone:256-265-1000
Mailing Address - Fax:256-265-9551
Practice Address - Street 1:101 SIVLEY RD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4421
Practice Address - Country:US
Practice Address - Phone:256-265-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HEALTHCARE AUTHORITY OF THE CITY OF HUNTSVILLE DBA HUNTSVILLE HOS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-12
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10378273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL021OtherBLUE CROSS BLUE SHIELD
ALHOS0039HMedicaid
TN10415OtherBLUE CROSS BLUE SHEILD
TN10415OtherBLUE CROSS BLUE SHEILD