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General NPI Number Information
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NPI Number | 1508938200
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Entity Type | Organization
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Legal Business Name | SOUTHERN RURAL HEALTH CARE CONSORTIUM
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 16410 HWY 72
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City | ROGERSVILLE
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State | AL
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Zip | 35652
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Country | US
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Telephone | 256-332-1631
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Fax | 256-332-4600
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Provider Business Mailing Address
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Address Line | PO BOX 970
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City | RUSSELLVILLE
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State | AL
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Zip | 35653-0970
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Country | US
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Telephone | 256-332-1631
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Fax | 256-332-4600
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. KATHY L HALL
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Credential |
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Telephone | 256-332-1631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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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 | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | AL
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