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General NPI Number Information
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NPI Number | 1831156462
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Entity Type | Organization
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Legal Business Name | RUSSELL COUNTY MEDICAL CENTER INC
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 116 FLANAGAN AVE SUITE C
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City | LEBANON
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State | VA
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Zip | 24266-4514
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Country | US
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Telephone | 276-883-8484
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Fax | 276-883-8495
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Provider Business Mailing Address
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Address Line | PO BOX 3600 SUITE C
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City | LEBANON
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State | VA
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Zip | 24266-0200
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Country | US
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Telephone | 276-883-8484
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Fax | 276-883-8495
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Authorized Official
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Title or Position | AGENCY DIRECTOR
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Name | MRS. KAREN J FIELDS
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Credential | RN
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Telephone | 276-883-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | HSP-0655
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License Number State | VA
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