Organization Name: | CORRECTIONAL MEDICAL SERVICES |
NPI Number: | 1164625968 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DELANO ROGER BENJAMIN (MEDICAL DIRECTOR) |
Mailing Address: | 1000 Saint Clair Rd Springville |
State: | AL US |
Postal Code: | 351465582 |
Phone Number: | 2054676111 |
Fax Number: | 2054676738 |
NPI Enumeration Date: | 06/08/2007 |
NPI Last Update Date: | 10/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | 24889 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |