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NPI Code Detail

MEDICARE: COMMUNITY HOSPITAL CLINICAL LAB

MEDICARE: COMMUNITY HOSPITAL CLINICAL LAB
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
1291U00000XClinical Medical LaboratoryH2602AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1510-05394OTHERALBCBS PROVIDER NUMBER

General Provider Information

NPI Number : 1568590339
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HOSPITAL CLINICAL LAB
Provider Business Mailing Address
First Line : 805 FRIENDSHIP RD
Second Line :
City : TALLASSEE
State : AL
Zip : 36078-1234
Country : US
Telephone Number : 334-283-6541
Fax Number :
Provider Business Practice Location Address
First Line : 875 FRIENDSHIP RD
Second Line :
City : TALLASSEE
State : AL
Zip : 36078-1234
Country : US
Telephone Number : 334-283-3734
Fax Number :
Authorized Official
Title or Position : CFO
Name : MR. LEE S GREER
Credential :
Telephone Number : 334-283-3734
Provider Enumeration Date : 03/01/2007
Last Update Date : 08/22/2020

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Directions to “COMMUNITY HOSPITAL CLINICAL LAB ” Practice Location

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