Healthcare Provider Details

I. General information

NPI: 1285946863
Provider Name (Legal Business Name): GREENE COUNTY HEALTH SYSTEM HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 07/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 WILSON AVE SUITE 3
EUTAW AL
35462-1136
US

IV. Provider business mailing address

509 WILSON AVE.
EUTAW AL
35462-1064
US

V. Phone/Fax

Practice location:
  • Phone: 205-372-2399
  • Fax: 205-372-3316
Mailing address:
  • Phone: 205-372-3388
  • Fax: 205-372-2716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ELMORE PATTERSON
Title or Position: CEO
Credential:
Phone: 205-372-3388