Healthcare Provider Details

I. General information

NPI: 1760766596
Provider Name (Legal Business Name): ESCAMBIA COUNTY HEALTH CARE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 BELLEVILLE AVE
BREWTON AL
36426-1306
US

IV. Provider business mailing address

PO BOX 908
BREWTON AL
36427-0908
US

V. Phone/Fax

Practice location:
  • Phone: 251-809-8398
  • Fax: 251-809-8459
Mailing address:
  • Phone: 251-809-8398
  • Fax: 251-809-8459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number197
License Number StateAL

VIII. Authorized Official

Name: MR. CHRIS B GRIFFIN
Title or Position: DIRECTOR
Credential:
Phone: 251-809-8398