Healthcare Provider Details

I. General information

NPI: 1497752281
Provider Name (Legal Business Name): NOLAND HOSPITAL DOTHAN II, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 ROSS CLARK CIR FL 4
DOTHAN AL
36301-3022
US

IV. Provider business mailing address

600 CORPORATE PKWY STE 100
BIRMINGHAM AL
35242-5451
US

V. Phone/Fax

Practice location:
  • Phone: 334-699-4300
  • Fax: 334-699-4379
Mailing address:
  • Phone: 205-783-8470
  • Fax: 205-783-8441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License NumberH3506
License Number StateAL

VIII. Authorized Official

Name: NICHOLAS V RENDA
Title or Position: EVP/CFO
Credential:
Phone: 205-783-8460