# MIZELL MEMORIAL HOSPITAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013937705
- **Authorized official:** MRS. JANA WYATT CPA (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (334) 493-9111

## Contact information

- **Practice address:** 702 N MAIN ST, OPP, AL 36467-1626
- **Practice address phone:** (334) 493-3541
- **Practice address fax:** (334) 493-9433
- **Mailing address:** PO BOX 1010, OPP, AL 36467-1010
- **Mailing address phone:** (334) 493-3541
- **Mailing address fax:** (334) 493-3789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QL0400X | Lithotripsy Clinic/Center | — | NULL | — |
| 273R00000X | Psychiatric Hospital Unit | — | AL | — |
| 275N00000X | Medicare Defined Swing Bed Hospital Unit | — | AL | — |
| 282NR1301X | Rural Acute Care Hospital | 11789 | AL | Yes |

## Other

- **Enumeration date:** 07/19/2006
- **Last updated:** 12/24/2019