Healthcare Provider Details

I. General information

NPI: 1578734976
Provider Name (Legal Business Name): MARION REGIONAL MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2008
Last Update Date: 11/11/2011
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 TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License NumberH4703
License Number StateAL

VIII. Authorized Official

Name: MR. JOSEPH A REPPERT
Title or Position: CFO
Credential:
Phone: 662-377-3978