Organization
HOUSTON COUNTY HEALTHCARE AUTHORITY
Active
Other names
Southeast Alabama Medical Center, Southeast Health Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT DEREK MILLER (CFO)
(334) 793-8701
Entity
Organization
Contact information
Practice address
1108 ROSS CLARK CIRCLE, DOTHAN, AL 36301-3022
(334) 793-8111
(334) 793-8779
Mailing address
PO BOX 6987, DOTHAN, AL 36302-6987
(334) 793-8111
(334) 793-8779
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
10358
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000001735A
—
GA
01
—
010057
BLUE CROSS
AL
05
—
010206700
—
FL
05
—
HOS0001H
—
AL
Enumeration date
11/09/2005
Last updated
10/25/2018
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