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General NPI Number Information
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NPI Number | 1164550489
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Entity Type | Organization
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Legal Business Name | NOTASULGA HEALTHCARE
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/22/2007
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Provider Practice Location Address
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Address Line | 56 WEST MAIN STREET
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City | NOTASULGA
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State | AL
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Zip | 36866-0100
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Country | US
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Telephone | 334-283-3734
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100
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City | NOTASULGA
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State | AL
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Zip | 36866-0100
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Country | US
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Telephone | 334-283-3734
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. LEE S GREER
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Credential |
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Telephone | 334-283-3734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1-090975
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License Number State | AL
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