Healthcare Provider Details

I. General information

NPI: 1548251366
Provider Name (Legal Business Name): CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2005
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 48TH ST
VALLEY AL
36854-3666
US

IV. Provider business mailing address

PO BOX 348 4800 48TH ST
VALLEY AL
36854-3666
US

V. Phone/Fax

Practice location:
  • Phone: 334-756-1648
  • Fax: 334-756-5874
Mailing address:
  • Phone: 334-756-1648
  • Fax: 334-756-5874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number001809
License Number StateAL

VIII. Authorized Official

Name: FRANK OPRANDY III
Title or Position: CFO
Credential:
Phone: 334-756-1495