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General NPI Number Information
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NPI Number | 1184679938
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Entity Type | Organization
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Legal Business Name | FORT PAYNE RHC CORP
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | 415 MEDICAL CENTER DR SW
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City | FORT PAYNE
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State | AL
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Zip | 35968-3421
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Country | US
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Telephone | 256-997-2820
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Fax | 256-997-2890
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Provider Business Mailing Address
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Address Line | 1573 MALLORY LN STE 100
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City | BRENTWOOD
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State | TN
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Zip | 37027-2895
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Country | US
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Telephone | 152-221-1400
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Fax | 615-465-3007
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Authorized Official
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Title or Position | SR. DIRECTOR PHYSICIAN REV CYCLE
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Name | LAURA J FEY
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Credential |
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Telephone | 615-221-3641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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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 | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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