Healthcare Provider Details
I. General information
NPI: 1982941381
Provider Name (Legal Business Name): COMMUNITY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2013
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
875 FRIENDSHIP RD
TALLASSEE AL
36078-1234
US
IV. Provider business mailing address
875 FRIENDSHIP RD
TALLASSEE AL
36078-1234
US
V. Phone/Fax
- Phone: 334-283-3111
- Fax:
- Phone: 334-283-3111
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LEE
S
GREER
Title or Position: CFO
Credential:
Phone: 334-283-3754