Healthcare Provider Details

I. General information

NPI: 1407010416
Provider Name (Legal Business Name): MARION REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1256 MILITARY ST S
HAMILTON AL
35570-5003
US

IV. Provider business mailing address

1256 MILITARY ST S
HAMILTON AL
35570-5003
US

V. Phone/Fax

Practice location:
  • Phone: 205-921-6200
  • Fax: 205-921-6260
Mailing address:
  • Phone: 205-921-6200
  • Fax: 205-921-6260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number11841
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number11841
License Number StateAL

VIII. Authorized Official

Name: MRS. DIANE KARR
Title or Position: BUSINESS SERVICE DIRECTOR
Credential:
Phone: 205-921-6250