Healthcare Provider Details

I. General information

NPI: 1740895200
Provider Name (Legal Business Name): ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 E. LAUREL STREET
ATMORE AL
36502
US

IV. Provider business mailing address

609 E. LAUREL STREET
ATMORE AL
36502
US

V. Phone/Fax

Practice location:
  • Phone: 251-368-6960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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