Healthcare Provider Details
I. General information
NPI: 1013355106
Provider Name (Legal Business Name): RUSH HOSPITAL/BUTLER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2013
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1404 E PUSHMATAHA ST
BUTLER AL
36904-2728
US
IV. Provider business mailing address
DEPT 3022, P.O. BOX 1000
MEMPHIS TN
38148-3022
US
V. Phone/Fax
- Phone: 205-459-4488
- Fax: 205-459-3010
- Phone: 601-213-3010
- Fax: 601-213-3011
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DON
LARKIN
KENNEDY
Title or Position: REGIONAL CEO
Credential:
Phone: 601-703-9614