1053172874 NPI number — HH HEALTH SYSTEM - DEKALB RHC, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053172874 NPI number — HH HEALTH SYSTEM - DEKALB RHC, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HH HEALTH SYSTEM - DEKALB RHC, LLC
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:
Provider Other Organization Name Type Code:
6
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:
1053172874
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 38074
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELFAST
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04915-1222
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-801-6048
Provider Business Mailing Address Fax Number:
256-265-2842

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
415 MEDICAL CENTER DR SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT PAYNE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35968-3421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-997-2820
Provider Business Practice Location Address Fax Number:
256-997-2512
Provider Enumeration Date:
01/18/2024

Additional Information

Authorized Official

Authorized Official Last Name:
CARTER
Authorized Official First Name:
CLINTON
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
256-801-6048

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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