Hale County Hospital

Organization Active NPI Emergency Medicine Physician · Greensboro, AL

NPI 1124356563 · NPPES record last updated Jun 16, 2022

Key facts

NPI
1124356563
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 207P00000X
License
H3301 (AL)
Legal business name
HALE COUNTY HOSPITAL
Practice address
508 Greene St
Greensboro, AL 36744-2316
Phone
(334) 624-3024
Fax
(334) 624-4453
NPI assigned
Nov 23, 2009
Organization subpart
Yes
Parent organization (as reported)
HALE COUNTY HOSPITAL

Authorized official

Name
Thomas Ogden Lackey
Title
Administrator
Phone
(334) 624-3024

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 5

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

Practitioners 22

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040624000445 AL Part B Supplier - Clinic/Group Practice 3375528169 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
Practice locations: Greensboro, AL

National Provider Directory

Part of
Hale Co Hospital Clinic

Locations

508 Greene St
#2
Greensboro, AL 36744
Phone (334) 624-3024

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207P00000X H3301 AL Yes
Hospitalist Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208M00000X H3301 AL

Addresses

Primary practice location

508 Greene St
Greensboro, AL 36744-2316

Mailing address

508 Greene St
Greensboro, AL 36744-2316
Phone (334) 624-3024

Other names

  • HALE COUNTY PHYSICIAN GROUP Doing business as

Other providers in Greensboro, AL

All providers in Greensboro, AL · Emergency Medicine Physician in Alabama

Sources for this page

Verify at the official NPI Registry.