Provider Demographics
NPI:1851487656
Name:CRENSHAW COUNTY HEALTH CARE AUTHORITY
Entity Type:Organization
Organization Name:CRENSHAW COUNTY HEALTH CARE AUTHORITY
Other - Org Name:THE HOSPITAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:KIMBRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-335-3374
Mailing Address - Street 1:101 HOSPITAL CIR
Mailing Address - Street 2:
Mailing Address - City:LUVERNE
Mailing Address - State:AL
Mailing Address - Zip Code:36049-7329
Mailing Address - Country:US
Mailing Address - Phone:334-335-1209
Mailing Address - Fax:334-335-1208
Practice Address - Street 1:101 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:LUVERNE
Practice Address - State:AL
Practice Address - Zip Code:36049-7329
Practice Address - Country:US
Practice Address - Phone:334-335-1209
Practice Address - Fax:334-335-1208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALTHE7140AMedicaid
AL515-14885OtherBC PROVIDER NUMBER
AL515-14885OtherBC PROVIDER NUMBER