Healthcare Provider Details

I. General information

NPI: 1073601043
Provider Name (Legal Business Name): HH HEALTH SYSTEM - SHOALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 HOSPITAL RD
RED BAY AL
35582-3858
US

IV. Provider business mailing address

PO BOX 490
RED BAY AL
35582-0490
US

V. Phone/Fax

Practice location:
  • Phone: 256-386-4011
  • Fax: 256-386-4685
Mailing address:
  • Phone: 256-386-4011
  • Fax: 256-386-4685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number11805
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number11805
License Number StateAL

VIII. Authorized Official

Name: MR. VINCENT BONETTI
Title or Position: EXECUTIVE DIRECTOR, REVENUE CYCLE
Credential:
Phone: 256-265-9641