Provider Demographics
NPI:1689625907
Name:GROVE HILL MEMORIAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:GROVE HILL MEMORIAL HOSPITAL, INC.
Other - Org Name:SOUTHERN OAKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:H
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:SEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-275-3191
Mailing Address - Street 1:PO BOX 935
Mailing Address - Street 2:
Mailing Address - City:GROVE HILL
Mailing Address - State:AL
Mailing Address - Zip Code:36451-0935
Mailing Address - Country:US
Mailing Address - Phone:251-275-3191
Mailing Address - Fax:
Practice Address - Street 1:295 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:GROVE HILL
Practice Address - State:AL
Practice Address - Zip Code:36451-3231
Practice Address - Country:US
Practice Address - Phone:251-275-3191
Practice Address - Fax:251-275-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01S091Medicare Oscar/Certification