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General NPI Number Information
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NPI Number | 1033292511
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Entity Type | Organization
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Legal Business Name | CLEBURNE COUNTY HOSPITAL BOARD, INC.
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 122 BROCKFORD RD
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City | HEFLIN
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State | AL
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Zip | 36264-7103
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Country | US
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Telephone | 256-463-2121
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Fax | 256-463-7791
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Provider Business Mailing Address
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Address Line | 122 BROCKFORD RD
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City | HEFLIN
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State | AL
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Zip | 36264-7103
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Country | US
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Telephone | 256-463-2121
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Fax | 256-463-7791
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. EURA HARRELL
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Credential | ADMINISTRATORS LICEN
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Telephone | 256-463-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 12503
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number | N1501
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | N1501
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | N1501
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License Number State | AL
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