Healthcare Provider Details

I. General information

NPI: 1316015241
Provider Name (Legal Business Name): RUSSELLVILLE HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15155 HIGHWAY 43
RUSSELLVILLE AL
35653-1975
US

IV. Provider business mailing address

15155 HIGHWAY 43
RUSSELLVILLE AL
35653-1975
US

V. Phone/Fax

Practice location:
  • Phone: 256-332-1611
  • Fax: 256-332-8674
Mailing address:
  • Phone: 256-332-1611
  • Fax: 256-332-8674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number10351
License Number StateAL

VIII. Authorized Official

Name: STEPHEN N. CLAPP
Title or Position: PRESIDENT/CEO
Credential:
Phone: 865-269-4074