MEDICARE: CLANTON HOSPITAL, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	1284-HHA	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063412880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLANTON HOSPITAL, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1920
Second Line	:
City	:	CLANTON
State	:	AL
Zip	:	35046-1920
Country	:	US
Telephone Number	:	205-280-4663
Fax Number	:	205-280-3481

Provider Business Practice Location Address
First Line	:	1010 LAY DAM RD
Second Line	:
City	:	CLANTON
State	:	AL
Zip	:	35045-2306
Country	:	US
Telephone Number	:	205-280-4663
Fax Number	:	205-280-3481

Authorized Official
Title or Position	:	CEO
Name	:	MR. ROB FOLLOWELL
Credential	:
Telephone Number	:	205-280-3503

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	06/23/2008

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1010 LAY DAM RD
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35045-2306

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1669428090 — CLANTON EMERGENCY PHYSICIANS, LLC
Practice Location Address:

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1710934872 — DR. MARK MOHAMMED ZAHID MD
Practice Location Address:

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Practice Phone: 205-280-3218
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1760421671 — DR. WAYNE BERNARD BAREFIELD D.O.
Practice Location Address:

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35045-2306

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1407890072 — DR. WILLIAM SAMUEL HERRING M.D.
Practice Location Address:

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1326074873 — DR. WADE B. NAVEN M.D.
Practice Location Address:

1010 LAY DAM RD
CLANTON, AL
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Directions to “CLANTON HOSPITAL, LLC ” Practice Location

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