Provider Demographics
NPI:1629133673
Name:CLAY COUNTY HEALTHCARE AUTHORITY
Entity Type:Organization
Organization Name:CLAY COUNTY HEALTHCARE AUTHORITY
Other - Org Name:CLAY COUNTY HOSPITAL AND NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-354-2131
Mailing Address - Street 1:PO BOX 1270
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36251-1270
Mailing Address - Country:US
Mailing Address - Phone:256-354-1160
Mailing Address - Fax:256-354-1246
Practice Address - Street 1:838255 HWY 9
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:AL
Practice Address - Zip Code:36251
Practice Address - Country:US
Practice Address - Phone:256-354-1160
Practice Address - Fax:256-354-1246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X, 3336L0003X
AL1200753336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100010050Medicaid
1990224OtherPK