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NPI Code Detail

MEDICARE: GENEVA COUNTY HEALTHCARE AUTHORITY, INC.

MEDICARE: GENEVA COUNTY HEALTHCARE AUTHORITY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility4772AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1010539OTHERALBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144317090
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENEVA COUNTY HEALTHCARE AUTHORITY, INC.
Provider Business Mailing Address
First Line : 1200 W MAPLE AVE
Second Line :
City : GENEVA
State : AL
Zip : 36340-1642
Country : US
Telephone Number : 334-684-3655
Fax Number :
Provider Business Practice Location Address
First Line : 1200 W MAPLE AVE
Second Line :
City : GENEVA
State : AL
Zip : 36340-1642
Country : US
Telephone Number : 334-684-3655
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. JANETTE SCROGGINS
Credential :
Telephone Number : 334-684-3655
Provider Enumeration Date : 10/10/2006
Last Update Date : 04/06/2010

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1801931944 — GENEVA COUNTY HEALTHCARE AUTHORITY, INC.
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1200 W MAPLE AVE
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36340-1642
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Directions to “GENEVA COUNTY HEALTHCARE AUTHORITY, INC. ” Practice Location

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