1932160082 NPI number — MARION REGIONAL MEDICAL CENTER, INC.

Table of content: (NPI 1932160082)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932160082 NPI number — MARION REGIONAL MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARION REGIONAL MEDICAL CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MARION REGIONAL MEDICAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932160082
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1256 MILITARY ST S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35570-5003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-921-6200
Provider Business Mailing Address Fax Number:
205-921-6260

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1256 MILITARY ST S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35570-5003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-921-6200
Provider Business Practice Location Address Fax Number:
205-921-6260
Provider Enumeration Date:
03/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
REPPERT
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
662-377-3978

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  H4703 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010-156 . This is a "BLUE CROSS PROVIDER NUMBE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: HOS0044H , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0431192 . This is a "HEALTHSPRINGS PROVIDER NU" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 07929201 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00220220 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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