Provider Demographics
NPI:1790185247
Name:EWH INC
Entity Type:Organization
Organization Name:EWH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROOK
Authorized Official - Middle Name:
Authorized Official - Last Name:HITCHCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-500-8755
Mailing Address - Street 1:23010 HIGHWAY 5
Mailing Address - Street 2:
Mailing Address - City:WEST BLOCTON
Mailing Address - State:AL
Mailing Address - Zip Code:35184-2672
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23010 HIGHWAY 5
Practice Address - Street 2:
Practice Address - City:WEST BLOCTON
Practice Address - State:AL
Practice Address - Zip Code:35184-2672
Practice Address - Country:US
Practice Address - Phone:310-500-8755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health