# GREENE COUNTY HOSPITAL & NURSING HOME

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GREENE COUNTY HOSPITAL & NURSING HOME
- **Other names:** Greene County Hospital Physicians' Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043389398
- **Legal business name:** GREENE COUNTY HOSPITAL & NURSING HOME
- **Authorized official:** MS. MARCIA PUGH (CHIEF EXECUTIVE OFFICER (CEO))
- **Authorized official phone:** (205) 994-8629

## Contact information

- **Practice address:** 607 WILSON AVE, EUTAW, AL 35462
- **Practice address phone:** (205) 372-4035
- **Practice address fax:** (205) 372-1228
- **Mailing address:** 607 WILSON AVE, EUTAW, AL 35462
- **Mailing address phone:** (205) 372-4035
- **Mailing address fax:** (205) 372-1228

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 02/15/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 010532 | BCBS | AL |
| 05 | — | 55890030 | — | AL |