Healthcare Provider Details

I. General information

NPI: 1164496691
Provider Name (Legal Business Name): BURNS NURSING HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 MONROE ST NW
RUSSELLVILLE AL
35653-1358
US

IV. Provider business mailing address

701 MONROE ST NW
RUSSELLVILLE AL
35653-1358
US

V. Phone/Fax

Practice location:
  • Phone: 256-332-4110
  • Fax: 256-332-4163
Mailing address:
  • Phone: 256-332-4110
  • Fax: 256-332-4163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MARK S DEARMAN
Title or Position: ADMINISTRATOR
Credential: N.H.A.
Phone: 256-332-4110