Healthcare Provider Details

I. General information

NPI: 1609505916
Provider Name (Legal Business Name): ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 MEDICAL PARK DR
ATMORE AL
36502-3016
US

IV. Provider business mailing address

PO BOX 11407 DEPT# 8332
BIRMINGHAM AL
35246-8332
US

V. Phone/Fax

Practice location:
  • Phone: 251-368-6878
  • Fax: 251-368-4551
Mailing address:
  • Phone: 251-368-6245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN S JOHNSON
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 251-282-0981