Provider Demographics
NPI:1699202341
Name:MONROE COUNTY HEALTH CARE AUTHORITY
Entity Type:Organization
Organization Name:MONROE COUNTY HEALTH CARE AUTHORITY
Other - Org Name:HOSPICE OF MONROE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRANNON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:251-743-7477
Mailing Address - Street 1:2016 S ALABAMA AVE
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36460-3044
Mailing Address - Country:US
Mailing Address - Phone:251-575-3111
Mailing Address - Fax:
Practice Address - Street 1:2016 S ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-3044
Practice Address - Country:US
Practice Address - Phone:251-575-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONROE COUNTY HOSPITAL BOARD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15638251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based