Healthcare Provider Details

I. General information

NPI: 1811120058
Provider Name (Legal Business Name): RACHAEL SUZANNE MCCOLLUM BC-HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHAEL SUZANNE MCCOLLUM BC-HIS

II. Dates (important events)

Enumeration Date: 09/03/2009
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 SOMERVILLE RD SE
DECATUR AL
35601-4335
US

IV. Provider business mailing address

1208 SOMERVILLE RD SE
DECATUR AL
35601-4335
US

V. Phone/Fax

Practice location:
  • Phone: 256-822-2211
  • Fax:
Mailing address:
  • Phone: 256-822-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number4175
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: