Basic Information
| Provider Information | |||||||||
| NPI: | 1063483592 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NATIONAL HEALTHCARE OF CULLMAN, INC. | ||||||||
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| OtherOrganizationName: | WOODLAND MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 CORPORATE CENTRE DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370672662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157643009 | ||||||||
| FaxNumber: | 6157643030 | ||||||||
| Practice Location | |||||||||
| Address1: | 1910 CHEROKEE AVE SW | ||||||||
| Address2: | |||||||||
| City: | CULLMAN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350555502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567393500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2006 | ||||||||
| LastUpdateDate: | 06/23/2009 | ||||||||
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| AuthorizedOfficialLastName: | COFFEY | ||||||||
| AuthorizedOfficialFirstName: | S | ||||||||
| AuthorizedOfficialMiddleName: | RAY | ||||||||
| AuthorizedOfficialTitleorPosition: | VP, REIMBURSEMENT | ||||||||
| AuthorizedOfficialTelephone: | 8883739600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 10338 | AL | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | HOS0143H | 05 | AL | MEDICAID | 1267630 | 01 | UNITED MINE WORKERS | OTHER | 320936 | 01 | BLACK LUNG | OTHER | 105 | 01 | BCBS | OTHER | 231929700 | 01 | W/C OP | OTHER | 01WOCH | 01 | COMPLETE HEALTH | OTHER |