Provider Demographics
NPI:1861576688
Name:COLBERT CO NORTHWEST AL HEALTHCARE AUTHORITY
Entity type:Organization
Organization Name:COLBERT CO NORTHWEST AL HEALTHCARE AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-386-4553
Mailing Address - Street 1:PO BOX 490
Mailing Address - Street 2:
Mailing Address - City:RED BAY
Mailing Address - State:AL
Mailing Address - Zip Code:35582-0490
Mailing Address - Country:US
Mailing Address - Phone:256-386-4011
Mailing Address - Fax:256-386-4685
Practice Address - Street 1:211 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:RED BAY
Practice Address - State:AL
Practice Address - Zip Code:35582-3858
Practice Address - Country:US
Practice Address - Phone:256-386-4011
Practice Address - Fax:256-386-4685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11660251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51532493OtherBLUE CROSS
ALPIC1632EMedicaid
ALPIC1632EMedicaid