Organization
IVY CREEK OF ELMORE, LLC
Active
Parent organization
IVY CREEK OF ELMORE, LLC
Other names
Anesthesia @ Elmore Comm. Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
IVY CREEK OF ELMORE, LLC
Authorized official
MICHAEL D BRUCE (CEO)
(334) 567-4311
Entity
Organization
Contact information
Practice address
500 HOSPITAL DR, WETUMPKA, AL 36092-1625
(334) 567-4311
(334) 567-4312
Mailing address
500 HOSPITAL DR, WETUMPKA, AL 36092-1625
(334) 567-4311
(334) 567-4312
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
04/22/2010
Last updated
01/27/2012
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