Provider Demographics
NPI:1720331481
Name:PICKENS COUNTY HEALTH CARE AUTHORITY
Entity type:Organization
Organization Name:PICKENS COUNTY HEALTH CARE AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCBRYDE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:205-367-8111
Mailing Address - Street 1:241 ROBERT K WILSON DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:AL
Mailing Address - Zip Code:35447-0478
Mailing Address - Country:US
Mailing Address - Phone:205-367-8111
Mailing Address - Fax:
Practice Address - Street 1:241 ROBERT K WILSON DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:AL
Practice Address - Zip Code:35447-0478
Practice Address - Country:US
Practice Address - Phone:205-367-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALH5401282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital