Provider Demographics
NPI:1780927681
Name:THE DCH HEALTH CARE AUTHORITY
Entity type:Organization
Organization Name:THE DCH HEALTH CARE AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KERI
Authorized Official - Middle Name:H
Authorized Official - Last Name:HINDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-759-7378
Mailing Address - Street 1:809 UNIVERSITY BLVD E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2029
Mailing Address - Country:US
Mailing Address - Phone:205-759-7378
Mailing Address - Fax:205-759-6397
Practice Address - Street 1:1050 RUBY TYLER PKWY
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-2958
Practice Address - Country:US
Practice Address - Phone:205-759-7190
Practice Address - Fax:205-750-5648
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DCH REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-29
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALHOS0092HMedicaid
AL010041OtherBLUE CROSS
ALHOS0092HMedicaid