Organization
THE RUSSELL HOSPITAL CORPORATION
Active
Other names
Medical Park Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
LOTHER E PEACE III (PRESIDENT/CEO)
(256) 329-7147
Entity
Organization
Contact information
Practice address
1034 S TALLASSEE ST, DADEVILLE, AL 36853-1844
(256) 825-9900
(256) 825-6620
Mailing address
1034 S TALLASSEE ST, DADEVILLE, AL 36853-1844
(256) 825-9900
(256) 825-6620
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
11873
AL
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529906130
—
AL
01
—
CH4859
RAILROAD MEDICARE
AL
Enumeration date
07/15/2006
Last updated
02/13/2024
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