Healthcare Provider Details

I. General information

NPI: 1871657759
Provider Name (Legal Business Name): TOMBIGBEE HEALTHCARE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 US HIGHWAY 80 E
DEMOPOLIS AL
36732-3605
US

IV. Provider business mailing address

105 US HIGHWAY 80 E
DEMOPOLIS AL
36732-3605
US

V. Phone/Fax

Practice location:
  • Phone: 334-289-4000
  • Fax: 334-287-2594
Mailing address:
  • Phone: 334-289-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number StateAL

VIII. Authorized Official

Name: MR. DOUGLAS L BREWER
Title or Position: CEO ADMINISTRATOR
Credential:
Phone: 334-287-2500