Healthcare Provider Details

I. General information

NPI: 1538100052
Provider Name (Legal Business Name): MONROE COUNTY HEALTH CARE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2016 S ALABAMA AVE
MONROEVILLE AL
36460
US

IV. Provider business mailing address

P.O. BOX 886
MONROEVILLE AL
36461-0886
US

V. Phone/Fax

Practice location:
  • Phone: 251-743-7486
  • Fax: 251-743-7400
Mailing address:
  • Phone: 251-575-3111
  • Fax: 251-743-7445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: GLENDA GRIFFIN
Title or Position: IT SPECIALIST
Credential:
Phone: 251-575-3111