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General NPI Number Information
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NPI Number | 1174990626
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Entity Type | Organization
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Legal Business Name | THE RUSSELL HOSPITAL CORPORATION
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Dates
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Enumeration Date | 08/31/2015
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Last Update Date | 08/14/2018
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Provider Practice Location Address
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Address Line | 21342 AL HIGHWAY 9
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City | GOODWATER
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State | AL
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Zip | 35072
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Country | US
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Telephone | 256-743-1300
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Fax | 256-743-1301
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Provider Business Mailing Address
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Address Line | PO BOX 939
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City | ALEXANDER CITY
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State | AL
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Zip | 35011-0939
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Country | US
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Telephone | 256-329-1709
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Fax | 256-329-7213
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | LOTHER E PEACE III
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Credential |
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Telephone | 256-329-7188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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