MEDICARE: BALL HEALTHCARE - LOWNDES, 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
1	314000000X	Skilled Nursing Facility	12603	AL

Other Identifiers

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

General Provider Information

NPI Number	:	1346276938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALL HEALTHCARE - LOWNDES, INC.

Provider Business Mailing Address
First Line	:	1 SOUTHERN WAY
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36619-1210
Country	:	US
Telephone Number	:	251-433-9801
Fax Number	:	251-433-9807

Provider Business Practice Location Address
First Line	:	629 STATE HIGHWAY 21 SOUTH
Second Line	:
City	:	HAYNEVILLE
State	:	AL
Zip	:	36040-6033
Country	:	US
Telephone Number	:	334-548-5995
Fax Number	:	334-548-5980

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. JACQUELYN BURRELL GREENE
Credential	:
Telephone Number	:	334-548-5995

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	04/07/2025

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