Provider Demographics
NPI:1013903608
Name:THE CHEROKEE COUNTY HEALTH CARE AUTHORITY
Entity Type:Organization
Organization Name:THE CHEROKEE COUNTY HEALTH CARE AUTHORITY
Other - Org Name:CHEROKEE COUNTY HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-927-5778
Mailing Address - Street 1:877 CEDAR BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:CENTRE
Mailing Address - State:AL
Mailing Address - Zip Code:35960-1005
Mailing Address - Country:US
Mailing Address - Phone:256-927-5778
Mailing Address - Fax:256-927-6294
Practice Address - Street 1:877 CEDAR BLUFF RD
Practice Address - Street 2:
Practice Address - City:CENTRE
Practice Address - State:AL
Practice Address - Zip Code:35960-1005
Practice Address - Country:US
Practice Address - Phone:256-927-5778
Practice Address - Fax:256-927-6294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11125314000000X
ALN1001332B00000X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4753560SMedicaid
AL01-5200Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
AL0440840001Medicare NSC