Provider Demographics
NPI:1952470205
Name:GREENE COUNTY HOSPITAL HOME HEALTH
Entity Type:Organization
Organization Name:GREENE COUNTY HOSPITAL HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-372-3388
Mailing Address - Street 1:509 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:EUTAW
Mailing Address - State:AL
Mailing Address - Zip Code:35462-1064
Mailing Address - Country:US
Mailing Address - Phone:205-372-3299
Mailing Address - Fax:205-372-3316
Practice Address - Street 1:607 WILSON AVE
Practice Address - Street 2:
Practice Address - City:EUTAW
Practice Address - State:AL
Practice Address - Zip Code:35462
Practice Address - Country:US
Practice Address - Phone:205-372-3299
Practice Address - Fax:205-372-3316
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENE COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-08
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALGRE7102AMedicaid
017102Medicare ID - Type Unspecified