Healthcare Provider Details

I. General information

NPI: 1255355020
Provider Name (Legal Business Name): GADSDEN REGIONAL MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 GOODYEAR AVE
GADSDEN AL
35903-1195
US

IV. Provider business mailing address

PO BOX 404799
ATLANTA GA
30384-4799
US

V. Phone/Fax

Practice location:
  • Phone: 256-494-4585
  • Fax: 256-494-4474
Mailing address:
  • Phone: 256-494-4585
  • Fax: 256-494-4474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License NumberH2801
License Number StateAL

VIII. Authorized Official

Name: PAULA M LALOR
Title or Position: DIRECTOR/DELEGATED OFFICIAL
Credential:
Phone: 629-215-3953