Healthcare Provider Details

I. General information

NPI: 1750480406
Provider Name (Legal Business Name): CRENSHAW COUNTY HEALTH CARE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/25/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPITAL CIR
LUVERNE AL
36049-7329
US

IV. Provider business mailing address

PO BOX 5013
MONTGOMERY AL
36103-5013
US

V. Phone/Fax

Practice location:
  • Phone: 334-335-3374
  • Fax: 334-335-1119
Mailing address:
  • Phone: 334-386-0343
  • Fax: 334-386-0382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number11790
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ANDREW KIMBRO
Title or Position: CHAIRMAN
Credential:
Phone: 334-335-3374