Provider Demographics
NPI:1619983004
Name:THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON
Entity Type:Organization
Organization Name:THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON
Other - Org Name:RMC JACKSONVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-235-5646
Mailing Address - Street 1:1701 PELHAM RD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36265-3353
Mailing Address - Country:US
Mailing Address - Phone:256-782-4538
Mailing Address - Fax:256-782-4589
Practice Address - Street 1:1701 PELHAM RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AL
Practice Address - Zip Code:36265-3353
Practice Address - Country:US
Practice Address - Phone:256-435-4970
Practice Address - Fax:256-782-4589
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-31
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALH0804273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01S146Medicare Oscar/Certification
AL144383Medicaid