Provider Demographics
NPI:1598710980
Name:MONROE COUNTY HEALTH CARE AUTHORITY
Entity Type:Organization
Organization Name:MONROE COUNTY HEALTH CARE AUTHORITY
Other - Org Name:MCH HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:NALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-575-3111
Mailing Address - Street 1:PO BOX 886
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36461-0886
Mailing Address - Country:US
Mailing Address - Phone:251-575-9366
Mailing Address - Fax:251-575-3945
Practice Address - Street 1:2016 S ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460
Practice Address - Country:US
Practice Address - Phone:251-575-9366
Practice Address - Fax:251-575-3945
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONROE COUNTY HEALTH CARE AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-23
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL244332B00000X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100001002Medicaid
AL009708180Medicaid
AL51503942OtherBLUE CROSS HME PROVIDER
AL51047025OtherBLUE CROSS HHA PROVIDER
AL100001002Medicaid