Healthcare Provider Details

I. General information

NPI: 1942301569
Provider Name (Legal Business Name): GREENE COUNTY HOSPITAL & NURSING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 WILSON AVE
EUTAW AL
35462-1064
US

IV. Provider business mailing address

509 WILSON AVE
EUTAW AL
35462-1064
US

V. Phone/Fax

Practice location:
  • Phone: 205-372-4545
  • Fax: 205-372-5061
Mailing address:
  • Phone: 205-372-4545
  • Fax: 205-372-5061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. MARCIA PUGH
Title or Position: ADMINISTRATOR
Credential: DNP, RN
Phone: 205-372-3388