Provider Demographics
NPI:1942391230
Name:THE HEALTH CARE AUTHORITY FOR BAPTIST HEALTH AN AFFILIATE OF UABHS
Entity Type:Organization
Organization Name:THE HEALTH CARE AUTHORITY FOR BAPTIST HEALTH AN AFFILIATE OF UABHS
Other - Org Name:PRATTVILLE BAPTIST HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-747-4258
Mailing Address - Street 1:PO BOX 241145
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-1145
Mailing Address - Country:US
Mailing Address - Phone:334-747-4307
Mailing Address - Fax:334-747-4172
Practice Address - Street 1:124 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-3619
Practice Address - Country:US
Practice Address - Phone:334-361-4267
Practice Address - Fax:334-361-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11760282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALHOS01088Medicaid
LA1708437OtherLA MEDICAID
MS01672862OtherMS MEDICAID
AL030OtherBLUE CROSS BLUE SHIELD
AL=========OtherOTHER COMMERCIAL INS
AL=========OtherVIVA
AL=========005OtherCHAMPUS
AL=========OtherFED TAX ID
AL030OtherBLUE CROSS BLUE SHIELD
ALHOS01088Medicaid
LA1708437OtherLA MEDICAID