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NPI Code Detail

MEDICARE: ROANOKE HEALTHCARE AUTHORITY

MEDICARE: ROANOKE HEALTHCARE AUTHORITY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical LaboratoryH5601AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
151534246OTHERALPREFERRED LAB

General Provider Information

NPI Number : 1982810404
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROANOKE HEALTHCARE AUTHORITY
Provider Business Mailing Address
First Line : PO BOX 670
Second Line :
City : ROANOKE
State : AL
Zip : 36274-0670
Country : US
Telephone Number : 334-863-4111
Fax Number : 334-863-5427
Provider Business Practice Location Address
First Line : 59928 HIGHWAY 22
Second Line :
City : ROANOKE
State : AL
Zip : 36274-2410
Country : US
Telephone Number : 334-863-4111
Fax Number : 334-863-5427
Authorized Official
Title or Position : CEO
Name : MR. TIMOTHY HARLIN
Credential :
Telephone Number : 334-863-4111
Provider Enumeration Date : 05/14/2007
Last Update Date : 08/22/2020

Similar Medicare Providers

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Practice Location Address:
59928 HIGHWAY 22
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1760640163 — ROANOKE HEALTHCARE AUTHORITY
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Directions to “ROANOKE HEALTHCARE AUTHORITY ” Practice Location

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