Provider Demographics
NPI:1871015461
Name:MONROE COUNTY HEALTH CARE AUTHORITY
Entity Type:Organization
Organization Name:MONROE COUNTY HEALTH CARE AUTHORITY
Other - Org Name:MCH PHYSICIANS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PFS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-743-7485
Mailing Address - Street 1:PO BOX 886
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36461-0886
Mailing Address - Country:US
Mailing Address - Phone:251-575-3111
Mailing Address - Fax:251-743-7445
Practice Address - Street 1:2016 S ALABAMA AVE STE C
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:251-743-7445
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONROE COUNTY HOSPITAL BOARD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-14
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty