Healthcare Provider Details

I. General information

NPI: 1972527265
Provider Name (Legal Business Name): SYLACAUGA HEALTH CARE AUTHORITY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 04/27/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W HICKORY ST
SYLACAUGA AL
35150-2913
US

IV. Provider business mailing address

315 W HICKORY ST
SYLACAUGA AL
35150-2913
US

V. Phone/Fax

Practice location:
  • Phone: 256-401-4000
  • Fax:
Mailing address:
  • Phone: 256-401-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number11871
License Number StateAL

VIII. Authorized Official

Name: GLENN SISK
Title or Position: CEO
Credential:
Phone: 256-401-4604