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General NPI Number Information
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NPI Number | 1801224860
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Entity Type | Organization
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Legal Business Name | RED BAY HOSPITAL OUTPATIENT CLINIC
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 211 HOSPITAL RD
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City | RED BAY
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State | AL
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Zip | 35582-3858
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Country | US
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Telephone | 256-356-1134
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Fax |
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Provider Business Mailing Address
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Address Line | 211 HOSPITAL RD
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City | RED BAY
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State | AL
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Zip | 35582-3858
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. RYAN CAMPBELL
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Credential | FACHE
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Telephone | 256-386-5896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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