Geneva County Healthcare Authority Inc

Organization Active NPI Certified Registered Nurse Anesthetist · Geneva, AL

NPI 1003943531 · NPPES record last updated Nov 13, 2024

Key facts

NPI
1003943531
Entity type
Organization (NPI type 2)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
Legal business name
GENEVA COUNTY HEALTHCARE AUTHORITY INC
Practice address
1200 W Maple Ave
Geneva, AL 36340
Phone
(334) 684-3655
Fax
(334) 684-6564
NPI assigned
Feb 28, 2007
Organization subpart
No

Authorized official

Name
Mrs. Janet Smith
Title
Ceo
Phone
(334) 684-3655

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 35

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wiregrass Medical Center
Geneva, AL · CCN 011309
Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 17, 2013
Wiregrass Medical Center
Geneva, AL · CCN 01Z309
Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 17, 2013
Samson Rural Health Clinic
Samson, AL · CCN 018502
Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Nov 1, 2019
Nov 1, 2019

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190206002405 AL Part B Supplier - Clinic/Group Practice 0244222487 Receives reassigned benefits from 3 practitioners
Practice locations: Geneva, AL

National Provider Directory

Tax ID family
Geneva County Healthcare Authority Inc (8 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207PE0004X 11807 AL
Certified Registered Nurse Anesthetist
Group: 193200000X MULTI-SPECIALTY GROUP
367500000X Yes

Addresses

Primary practice location

1200 W Maple Ave
Geneva, AL 36340

Mailing address

1200 W Maple Ave
Geneva, AL 36340-1642
Phone (334) 684-3655

Other names

  • WIREGRASS MEDICAL CENTER Doing business as

Other providers in Geneva, AL

All providers in Geneva, AL · Certified Registered Nurse Anesthetist in Alabama

Sources for this page

Verify at the official NPI Registry.