Provider Demographics
NPI:1356515449
Name:ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC
Entity type:Organization
Organization Name:ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:NIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-2071
Mailing Address - Street 1:PO BOX 17106
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32522-7106
Mailing Address - Country:US
Mailing Address - Phone:850-469-2044
Mailing Address - Fax:850-434-4683
Practice Address - Street 1:401 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-3006
Practice Address - Country:US
Practice Address - Phone:251-368-6362
Practice Address - Fax:850-434-4683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH2702OtherLICENSE
ALH2702OtherLICENSE