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NPI Code Detail

MEDICARE: THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE - LV STABLER HOSPI

MEDICARE: THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE - LV STABLER HOSPI
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital10318AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2010158OTHERBCBS
382446OTHERBC LA

General Provider Information

NPI Number : 1780655332
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE - LV STABLER HOSPI
Provider Business Mailing Address
First Line : 29 L V STABLER DR
Second Line :
City : GREENVILLE
State : AL
Zip : 36037-3850
Country : US
Telephone Number : 334-383-2423
Fax Number : 334-382-0305
Provider Business Practice Location Address
First Line : 29 L V STABLER DR
Second Line :
City : GREENVILLE
State : AL
Zip : 36037-3850
Country : US
Telephone Number : 334-382-2671
Fax Number : 334-382-0305
Authorized Official
Title or Position : CFO
Name : DAVID GLENN WILCOX
Credential : CPA
Telephone Number : 334-383-2423
Provider Enumeration Date : 01/31/2006
Last Update Date : 03/25/2019

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1811968308 — THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE - LV STABLER HOSPI
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1962450577 — DR. WAYNE L. MARTIN M.D.
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Directions to “THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE - LV STABLER HOSPI ” Practice Location

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