MEDICARE: WASHINGTON COUNTY HEALTHCARE AUTHORITY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	363LP2300X	Primary Care Nurse Practitioner
3	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316223027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASHINGTON COUNTY HEALTHCARE AUTHORITY, INC

Provider Business Mailing Address
First Line	:	PO BOX 1299
Second Line	:
City	:	CHATOM
State	:	AL
Zip	:	36518-1299
Country	:	US
Telephone Number	:	251-847-2223
Fax Number	:	251-847-3808

Provider Business Practice Location Address
First Line	:	73 LONG STREET
Second Line	:
City	:	MILLRY
State	:	AL
Zip	:	36558
Country	:	US
Telephone Number	:	251-846-3233
Fax Number	:	251-846-3224

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	LESLEY JEAN DUNN
Credential	:
Telephone Number	:	251-847-2223

Provider Enumeration Date	:	10/26/2011
Last Update Date	:	04/09/2025

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