Organization
FORT PAYNE HOSPITAL CORPORATION
Active
Other names
Dekalb Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE HOLTSFORD (AUTH OFFICIAL/DIR BUSINESS OFFICE)
(615) 465-7466
Entity
Organization
Contact information
Practice address
200 MEDICAL CENTER DR SW, FORT PAYNE, AL 35968-3458
(256) 845-3150
Mailing address
200 MEDICAL CENTER DR SW, FORT PAYNE, AL 35968-3458
(256) 845-3150
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
—
—
282N00000X
General Acute Care Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119736 - PEC
—
AL
Enumeration date
01/18/2011
Last updated
01/18/2011
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