Provider Demographics
NPI:1336823632
Name:THE SYLACAUGA HEALTH CARE AUTHORITY
Entity Type:Organization
Organization Name:THE SYLACAUGA HEALTH CARE AUTHORITY
Other - Org Name:NIX FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-401-4534
Mailing Address - Street 1:33733 US HIGHWAY 280
Mailing Address - Street 2:
Mailing Address - City:CHILDERSBURG
Mailing Address - State:AL
Mailing Address - Zip Code:35044-3017
Mailing Address - Country:US
Mailing Address - Phone:256-378-3301
Mailing Address - Fax:
Practice Address - Street 1:33733 US HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:CHILDERSBURG
Practice Address - State:AL
Practice Address - Zip Code:35044-3017
Practice Address - Country:US
Practice Address - Phone:256-378-3301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health