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General NPI Number Information
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NPI Number | 1881849024
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Entity Type | Organization
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Legal Business Name | RUSSELL MEDICAL CENTER
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Dates
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Enumeration Date | 12/01/2008
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Last Update Date | 12/01/2008
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Provider Practice Location Address
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Address Line | US HWY 280 BY-PASS
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City | ALEXANDER CITY
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State | AL
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Zip | 35010
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Country | US
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Telephone | 256-329-7197
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Fax |
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Provider Business Mailing Address
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Address Line | US 280 BYPASS
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City | ALEXANDER CITY
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State | AL
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Zip | 35010
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Country | US
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Telephone | 256-329-7197
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Fax |
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Authorized Official
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Title or Position | PHARMACY DIRECTOR
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Name | MR. JERRY E. HOLLEY
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Credential | PHARMACIST
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Telephone | 256-329-7197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 180124
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License Number State | AL
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