Provider Demographics
NPI:1154972883
Name:THE HEALTH CARE AUTHORITY OF THE CITY OF EUFAULA
Entity type:Organization
Organization Name:THE HEALTH CARE AUTHORITY OF THE CITY OF EUFAULA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MSHA, CMPE
Authorized Official - Phone:334-688-7451
Mailing Address - Street 1:820 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-1822
Mailing Address - Country:US
Mailing Address - Phone:334-688-7451
Mailing Address - Fax:334-688-7423
Practice Address - Street 1:512 MAIN STREET
Practice Address - Street 2:
Practice Address - City:HURTSBORO
Practice Address - State:AL
Practice Address - Zip Code:36860
Practice Address - Country:US
Practice Address - Phone:334-232-6551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HEALTH CARE AUTHORITY OF THE CITY OF EUFAULA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty