Organization
CRENSHAW COUNTY HEALTH CARE AUTHORITY
Active
Parent organization
CRENSHAW COUNTY HEALTH CARE AUTHORITY
Other names
Crenshaw Family Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRENSHAW COUNTY HEALTH CARE AUTHORITY
Authorized official
MICHAEL ANDREW KIMBRO (AUTHORIZED OFFICIAL)
(334) 335-3374
Entity
Organization
Contact information
Practice address
58 ROY BEALL DR, LUVERNE, AL 36049-6800
(334) 335-1212
(334) 335-1217
Mailing address
101 HOSPITAL CIRCLE, LUVERNE, AL 36049-7344
(334) 335-3374
(334) 335-1119
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051518337
BC PROVIDER NUMBER
AL
05
—
540003411
—
AL
Enumeration date
10/05/2006
Last updated
07/20/2020
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