Healthcare Provider Details

I. General information

NPI: 1700052701
Provider Name (Legal Business Name): HEALTHCARE AUTHORITY OF THE CITY OF HUNTSVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SIVLEY RD SW
HUNTSVILLE AL
35801-4421
US

IV. Provider business mailing address

PO BOX 21007
HUNTSVILLE AL
35813-5007
US

V. Phone/Fax

Practice location:
  • Phone: 256-265-3880
  • Fax: 256-265-3886
Mailing address:
  • Phone: 256-801-6036
  • Fax: 256-801-6218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: CLINTON CARTER
Title or Position: CFO
Credential:
Phone: 256-265-8818