Provider Demographics
NPI:1942207113
Name:CAPITOL HILL HEALTHCARE CENTER, INC
Entity Type:Organization
Organization Name:CAPITOL HILL HEALTHCARE CENTER, INC
Other - Org Name:CAPITOL HILL HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, NHA
Authorized Official - Phone:334-265-3900
Mailing Address - Street 1:520 S HULL ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-4610
Mailing Address - Country:US
Mailing Address - Phone:334-834-2920
Mailing Address - Fax:334-834-1145
Practice Address - Street 1:520 S HULL ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-4610
Practice Address - Country:US
Practice Address - Phone:334-834-2920
Practice Address - Fax:334-834-1145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-04
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL08387314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL010630OtherBC/BS OF AL
AL7100049OtherUNITED HEALTHCARE
AL012392OtherBC/BS OF AL
AL0431541OtherHEALTHSPRINGS OF AL
AL4757300SMedicaid
AL015390Medicare Oscar/Certification