# PICKENS COUNTY MEDICAL CENTER,INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PICKENS COUNTY MEDICAL CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164705380
- **Legal business name:** PICKENS COUNTY MEDICAL CENTER
- **Authorized official:** H WAYNE MCELROY (ADMINISTRATOR)
- **Authorized official phone:** (205) 367-8111

## Contact information

- **Practice address:** 241 ROBERT K WILSON DR, CARROLLTON, AL 35447-0478
- **Practice address phone:** (205) 367-2408
- **Practice address fax:** (205) 367-2121
- **Mailing address:** 241 ROBERT K WILSON DR, CARROLLTON, AL 35447-0478
- **Mailing address phone:** (205) 367-2408
- **Mailing address fax:** (205) 367-2121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 275N00000X | Medicare Defined Swing Bed Hospital Unit | H5401 | AL | Yes |

## Other

- **Enumeration date:** 09/23/2011
- **Last updated:** 03/08/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1164423679 | MEDICARE NPI | — |
| 05 | — | 47910905 | — | AL |