Organization Name: | CULLMAN REGIONAL MEDICAL CENTER |
NPI Number: | 1316112568 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JETE EDMISSON (CFO) |
Mailing Address: | 307 Main St Sw Hanceville |
State: | AL US |
Postal Code: | 350775476 |
Phone Number: | 2563520188 |
Fax Number: | 2563520187 |
NPI Enumeration Date: | 04/29/2008 |
NPI Last Update Date: | 04/06/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | H2201 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |