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General NPI Number Information
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NPI Number | 1972317212
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Entity Type | Organization
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Legal Business Name | RUSSELLVILLE HOSPITAL INC.
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 904 26TH ST
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City | HALEYVILLE
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State | AL
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Zip | 35565-1719
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Country | US
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Telephone | 205-486-5234
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1089
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City | RUSSELLVILLE
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State | AL
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Zip | 35653-1089
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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 | CHIEF EXECUTIVE OFFICER
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Name | ASHOKE MUKHERJI
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Credential |
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Telephone | 615-308-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 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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