| Organization Name: | HEALTHCARE AUTHORITY OF ELBA |
| NPI Number: | 1215235072 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELLEN C BRILEY (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 980 Drayton Ave Elba |
| State: | AL US |
| Postal Code: | 363231404 |
| Phone Number: | 3348973800 |
| Fax Number: | 3348973804 |
| NPI Enumeration Date: | 03/03/2011 |
| NPI Last Update Date: | 03/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | M030769 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |