Organization
HEALTHCARE AUTHORITY OF ELBA, AL, INC.
Active
Other names
Dr. Glenn Roberts
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN C. BRILEY RN (CHIEF EXECUTIVE OFFICER)
(334) 897-2257
Entity
Organization
Contact information
Practice address
978 DRAYTON AVE, ELBA, AL 36323-1404
(334) 897-2597
(334) 897-6662
Mailing address
978 DRAYTON AVE, ELBA, AL 36323-1404
(334) 897-2597
(334) 897-6662
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO314
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510-98808
BCBS OF AL
AL
Enumeration date
01/10/2007
Last updated
08/22/2020
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