Healthcare Provider Details

I. General information

NPI: 1356931364
Provider Name (Legal Business Name): THE EAST ALABAMA HEALTH CARE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2021
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CAMP AUBURN RD STE P101
AUBURN AL
36832-4746
US

IV. Provider business mailing address

900 CAMP AUBURN RD STE P101
AUBURN AL
36832-4746
US

V. Phone/Fax

Practice location:
  • Phone: 334-364-3050
  • Fax:
Mailing address:
  • Phone: 334-364-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL A PRICE JR.
Title or Position: CFO
Credential:
Phone: 334-528-1310