1114999406 NPI number — NATIONAL HEALTHCARE OF CULLMAN, INC.

Table of content: (NPI 1114999406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114999406 NPI number — NATIONAL HEALTHCARE OF CULLMAN, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL HEALTHCARE OF CULLMAN, 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:
WOODLAND 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:
1114999406
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 CORPORATE CENTRE DR STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067-2662
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-764-3009
Provider Business Mailing Address Fax Number:
615-764-3030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1910 CHEROKEE AVE SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CULLMAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35055-5502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-739-3500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COFFEY
Authorized Official First Name:
S
Authorized Official Middle Name:
RAY
Authorized Official Title or Position:
VP, REIMBURSEMENT
Authorized Official Telephone Number:
615-764-3009

Provider Taxonomy Codes

  • Taxonomy code: 273R00000X , with the licence number:  10338 , 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: HOS0143H , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".