Healthcare Provider Details

I. General information

NPI: 1306101639
Provider Name (Legal Business Name): ESCAMBIA COUNTY HEALTH CARE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 DOUGLAS AVE
BREWTON AL
36426-1579
US

IV. Provider business mailing address

1108 DOUGLAS AVE
BREWTON AL
36426-1579
US

V. Phone/Fax

Practice location:
  • Phone: 251-867-2797
  • Fax: 251-867-2799
Mailing address:
  • Phone: 251-867-2797
  • Fax: 251-867-2799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number900803
License Number StateAL

VIII. Authorized Official

Name: WES NALL
Title or Position: CEO
Credential:
Phone: 251-809-8435