Organization
HOUSTON COUNTY HEALTHCARE AUTHORITY
Active
Parent organization
HOUSTON COUNTY HEALTHCARE AUTHORITY
Other names
SAMC-ENTERPRISE MEDICAL CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOUSTON COUNTY HEALTHCARE AUTHORITY
Authorized official
CRYSTAL S FOSTER CPC (CONTRACT MANAGER)
(334) 793-8087
Entity
Organization
Contact information
Practice address
101 PROFESSIONAL LN, ENTERPRISE, AL 36330-2085
(334) 347-3404
(334) 393-0613
Mailing address
101 PROFESSIONAL LN, ENTERPRISE, AL 36330-2085
(334) 347-3404
(334) 393-0613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F945
BLUE CROSS BLUE SHIELD
AL
Enumeration date
01/09/2007
Last updated
11/01/2007
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