Provider Demographics
NPI:1841306099
Name:D. W. MCMILLAN MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:D. W. MCMILLAN MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-809-8333
Mailing Address - Street 1:114 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:BREWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36426-1516
Mailing Address - Country:US
Mailing Address - Phone:251-867-5054
Mailing Address - Fax:251-867-5135
Practice Address - Street 1:114 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-1516
Practice Address - Country:US
Practice Address - Phone:251-867-5054
Practice Address - Fax:251-867-5135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL012-00717OtherBC/BS OF ALABAMA
ALDWM7143-AMedicaid
ALDWM7143-AMedicaid