Healthcare Provider Details

I. General information

NPI: 1912081407
Provider Name (Legal Business Name): COMMUNITY HOSPITAL OF ANDALUSIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 S THREE NOTCH ST
ANDALUSIA AL
36420-5325
US

IV. Provider business mailing address

330 SEVEN SPRINGS WAY
BRENTWOOD TN
37027-4536
US

V. Phone/Fax

Practice location:
  • Phone: 334-222-8466
  • Fax: 334-427-0349
Mailing address:
  • Phone: 615-920-7000
  • Fax: 615-920-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: KATHY TEAGUE
Title or Position: VICE PRESIDENT, CORPORATE SECRETARY
Credential:
Phone: 629-253-5121