=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386615441
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NATIONAL HEALTHCARE OF DECATUR, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2006
-----------------------------------------------------
Last Update Date | 12/01/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1874 BELTLINE RD SW
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35601-5514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-350-2211
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 501 CORPORATE CENTRE DR SUITE 200
-----------------------------------------------------
City | FRANKLIN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37067-2659
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-764-3000
-----------------------------------------------------
Fax | 615-764-3030
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SENIOR VP, GROUP OPERATIONS
-----------------------------------------------------
Name | DANIEL S SLIPKOVICH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-764-3000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 10401
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------