Healthcare Provider Details

I. General information

NPI: 1508793951
Provider Name (Legal Business Name): BULLOCK COUNTY HEALTH CARE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 PRAIRIE ST N
UNION SPRINGS AL
36089-1417
US

IV. Provider business mailing address

308 PRAIRIE ST N
UNION SPRINGS AL
36089-1417
US

V. Phone/Fax

Practice location:
  • Phone: 334-738-1499
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. SAMUEL PRICE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 334-528-1310