Provider Demographics
NPI:1689380800
Name:THE SYLACAUGA HEALTH CARE AUTHORITY
Entity Type:Organization
Organization Name:THE SYLACAUGA HEALTH CARE AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:SISK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-401-4602
Mailing Address - Street 1:315 W HICKORY ST STE 151
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-2913
Mailing Address - Country:US
Mailing Address - Phone:256-401-4690
Mailing Address - Fax:256-401-4693
Practice Address - Street 1:315 W HICKORY ST STE 151
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2913
Practice Address - Country:US
Practice Address - Phone:256-401-4690
Practice Address - Fax:256-401-4693
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE SYLACAUGA HEALTH CARE AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy