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General NPI Number Information
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NPI Number | 1841453644
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Entity Type | Organization
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Legal Business Name | CITIZENS BAPTIST MEDICAL CENTER
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 604 STONE AVE
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City | TALLADEGA
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State | AL
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Zip | 35160-2217
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Country | US
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Telephone | 256-761-4363
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Fax | 263-761-4367
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Provider Business Mailing Address
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Address Line | 604 STONE AVE
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City | TALLADEGA
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State | AL
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Zip | 35160-2217
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Country | US
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Telephone | 256-761-4363
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Fax | 263-761-4367
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | MS. MILDRED TAYLOR CLINE
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Credential | MS CCC-SLP
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Telephone | 256-487-1946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 017156
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License Number State | AL
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