Healthcare Provider Details

I. General information

NPI: 1215976675
Provider Name (Legal Business Name): THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 18TH ST
ANNISTON AL
36207-3952
US

IV. Provider business mailing address

PO BOX 1380
ANNISTON AL
36202-1380
US

V. Phone/Fax

Practice location:
  • Phone: 256-235-8900
  • Fax: 256-235-8899
Mailing address:
  • Phone: 256-235-5860
  • Fax: 256-235-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QL0400X
TaxonomyLithotripsy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number10322
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LOUIS A BASS
Title or Position: CEO
Credential:
Phone: 256-235-5646