# RUSSELL COUNTY COMMUNITY HOSPITAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Summit Hospital ER Physicians
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679768311
- **Authorized official:** MR. JOHN L. JETER CPA (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (334) 732-3458

## Contact information

- **Practice address:** 4401 RIVER CHASE DR, PHENIX CITY, AL 36867-7483
- **Practice address phone:** (334) 732-3000
- **Practice address fax:** (334) 732-3020
- **Mailing address:** 4401 RIVER CHASE DR, PHENIX CITY, AL 36867-7483
- **Mailing address phone:** (334) 732-3000
- **Mailing address fax:** (334) 732-3020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | H5703 | AL | Yes |

## Other

- **Enumeration date:** 09/06/2007
- **Last updated:** 09/06/2007