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General NPI Number Information
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NPI Number | 1215089305
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Entity Type | Organization
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Legal Business Name | THE EAST ALABAMA HEALTH CARE AUTHORITY
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 2000 PEPPERELL PKWY STE 292 SUITE 292
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City | OPELIKA
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State | AL
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Zip | 36801-5452
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Country | US
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Telephone | 334-528-2293
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Fax | 334-528-4702
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Provider Business Mailing Address
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Address Line | 2000 PEPPERELL PKWY STE 292
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City | OPELIKA
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State | AL
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Zip | 36801-5452
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Country | US
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Telephone | 334-528-2293
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Fax | 334-528-4702
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Authorized Official
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Title or Position | CFO
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Name | SAMUEL A PRICE JR.
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Credential |
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Telephone | 334-528-1310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHNR001136
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 114653
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License Number State | AL
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