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General NPI Number Information
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NPI Number | 1093721391
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Entity Type | Organization
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Legal Business Name | DALE MEDICAL CENTER
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/02/2010
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Provider Practice Location Address
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Address Line | 126 HOSPITAL AVE
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City | OZARK
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State | AL
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Zip | 36360-2018
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Country | US
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Telephone | 334-774-2601
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Fax | 334-774-0258
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Provider Business Mailing Address
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Address Line | 126 HOSPITAL AVE
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City | OZARK
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State | AL
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Zip | 36360-2018
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Country | US
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Telephone | 334-774-2601
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Fax | 334-774-0258
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Authorized Official
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Title or Position | PHCY DIR
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Name | CHRISTOPHER STEVENS
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Credential | RPH
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Telephone | 334-774-2601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 130019
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License Number State | AL
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