Provider Demographics
NPI:1679196927
Name:D.W. MCMILLAN MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:D.W. MCMILLAN MEMORIAL HOSPITAL
Other - Org Name:D W MCMILLAN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-809-8429
Mailing Address - Street 1:1121 BELLEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:BREWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36426-1500
Mailing Address - Country:US
Mailing Address - Phone:251-867-6071
Mailing Address - Fax:251-867-5999
Practice Address - Street 1:1121 BELLEVILLE AVE
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-1500
Practice Address - Country:US
Practice Address - Phone:251-867-6071
Practice Address - Fax:251-867-5999
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D. W. MCMILLAN MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty