Provider Demographics
NPI:1285946863
Name:GREENE COUNTY HEALTH SYSTEM HOME HEALTH AGENCY
Entity type:Organization
Organization Name:GREENE COUNTY HEALTH SYSTEM HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELMORE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-372-3388
Mailing Address - Street 1:509 WILSON AVE.
Mailing Address - Street 2:
Mailing Address - City:EUTAW
Mailing Address - State:AL
Mailing Address - Zip Code:35462-1064
Mailing Address - Country:US
Mailing Address - Phone:205-372-3388
Mailing Address - Fax:205-372-2716
Practice Address - Street 1:607 WILSON AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:EUTAW
Practice Address - State:AL
Practice Address - Zip Code:35462-1136
Practice Address - Country:US
Practice Address - Phone:205-372-2399
Practice Address - Fax:205-372-3316
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENE COUNTY HOSPITAL & NURSING HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-12
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL017102Medicare Oscar/Certification