Organization
SOUTHERN RURAL HEALTH CARE CONSORTIUM INC.
Active
Other names
Children's Health of Decatur
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY L HALL (EXECUTIVE DIRECTOR)
(256) 332-1631
Entity
Organization
Contact information
Practice address
1304 13TH AVENUE S.E., SUITE A, DECATUR, AL 35601-0000
(256) 353-0178
(256) 353-6723
Mailing address
508 SAINT CLAIR ST SE, RUSSELLVILLE, AL 35653-2720
(256) 332-1631
(256) 332-4600
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-1898
MEDICARE #
AL
05
—
630002001
—
AL
Enumeration date
11/28/2006
Last updated
03/16/2011
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