Healthcare Provider Details

I. General information

NPI: 1659510931
Provider Name (Legal Business Name): ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 MEDICAL PARK DR
ATMORE AL
36502-3004
US

IV. Provider business mailing address

402 MEDICAL PARK DR
ATMORE AL
36502-3004
US

V. Phone/Fax

Practice location:
  • Phone: 251-368-7974
  • Fax: 251-368-5973
Mailing address:
  • Phone: 251-368-7974
  • Fax: 251-368-5973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY LOWERY
Title or Position: ADMINISTRATOR
Credential:
Phone: 251-368-6362