Southeast Alabama Regional Healthcare Authority

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SOUTHEAST ALABAMA REGIONAL HEALTHCARE AUTHORITY

Doing business as

MCB Family Clinic

Practice address

31 Railroad Street
Louisville, AL 36048

Phone

(334) 688-7272

Fax

(334) 688-7127

NPI assigned

Aug 25, 2009

Last updated

Aug 24, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ralph Clark

Title

Administrator

Phone

(334) 688-7276

Specialties & licenses 1

Addresses

Other names 1

• MCB Family Clinic Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503532800000",
    "number": "1801029822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W WASHINGTON ST",
            "city": "EUFAULA",
            "state": "AL",
            "postal_code": "360271822",
            "telephone_number": "334-688-7000",
            "fax_number": "334-688-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 RAILROAD STREET",
            "city": "LOUISVILLE",
            "state": "AL",
            "postal_code": "36048",
            "telephone_number": "334-688-7272",
            "fax_number": "334-688-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ALABAMA REGIONAL HEALTHCARE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-25",
        "last_updated": "2017-08-24",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-688-7276"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCB Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela Grace Baker, CRNP
• Melea Faith Brooks
• Johna Gayle Cotton, C.R.N.P.
• Kadrinne Kashun Johnson
• Quest Counseling Agency, LLC
• Southeast Alabama Youth Services, Inc
• The Health Care Authority of the City of Eufaula (MCB Family Clinic)
• Town of Louisville (Louisville Ambulance Service)

• Primary Care Clinic/Center in Louisville, AL
• Providers in Louisville, AL by specialty
• Primary Care Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.