HEALTHCARE AUTHORITY OF ELBA (NPI# 1215235072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215235072 |
Entity Type | Organization |
Organization Name | HEALTHCARE AUTHORITY OF ELBA |
Other Organization Name | JASON D. TUCKER, MD |
Practice Address |
980 Drayton Ave Elba AL 36323-1404 |
Practice Telephone | 3348973800 |
Practice Fax Number | 3348973804 |
Mailing Telephone | 3348973800 |
Mailing Fax Number | 3348973804 |
Enumeration Date | 2011-03-03 |
Last Update Date | 2011-03-03 |
Authorized Official Name | MS. ELLEN C BRILEY (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 3348972257 |
Authorized Official Credential | RN |
Is Organization Subpart | Y |
Parent Organization Name | HEALTHCARE AUTHORITY OF ELBA |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
M030769 | AL | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AL | STATE MEDICAL LICENSE NUMBER | M030769 | 01 |
INDIVIDUAL NPI | 91689839813 | 01 |
Other Name | Type Code |
---|---|
Jason D. Tucker, MD | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396939013 | Healthcare Authority of Elba | Skilled Nursing Facility | 987 Drayton Ave, Elba, AL 36323-1402 | 2007-09-06 |
Street Address |
980 DRAYTON AVE |
City | ELBA |
State | AL |
Zip Code | 36323-1404 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629114590 | The Healthcare Authority of Elba Alabama | Clinic/Center | 980 Drayton Ave, Elba, AL 36323-1404 | 2007-01-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972610947 | Timothy Michael Jackson | Dentist | 982 Drayton Avenue, Elba, AL 36323 | 2006-08-24 |
1467484493 | Freds Stores of Tennessee Inc | Pharmacy | 966 Hwy 203, Elba, AL 36323 | 2006-07-07 |
1871850297 | Noah Tucker Inpatient Services | Internal Medicine | 987 Drayton Street, Elba, AL 36323 | 2012-04-23 |
1356490197 | Coffee County Health Dept-elba Mat | Public Health or Welfare | North Court Avenue, Elba, AL 36323-0000 | 2007-01-10 |
1821123928 | State of Alabama Department of Public Health | Public Health or Welfare | North Court Avenue, Elba, AL 36323-0000 | 2007-02-22 |
1649314634 | Coffee County Health Dept-elba Vfc Immun | Public Health or Welfare | North Court Avenue, Elba, AL 36323-0000 | 2007-02-16 |
1669516373 | Coffee County Health Dept-elba Mat Cm | Case Management | North Court Avenue, Elba, AL 36323-0000 | 2007-02-16 |
1093859894 | Coffee County Health Dept-elba Epsdt Cm | Case Management | North Court Avenue, Elba, AL 36323-0000 | 2007-02-16 |
1710020896 | Coffee County Health Dept-elba Fp Cm | Case Management | North Court Avenue, Elba, AL 36323-0000 | 2007-02-15 |
1417090630 | Coffee County Health Dept-elba Epsdt | Public Health or Welfare | North Court Avenue, Elba, AL 36323-0000 | 2007-02-15 |
Find all providers in zip 36323 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629114590 | The Healthcare Authority of Elba Alabama | Clinic/Center | 980 Drayton Ave, Elba, AL 36323-1404 | 2007-01-29 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.