Organization
SOUTHERN RURAL HEALTH CARE CONSORTIUM, INC.
Active
Other names
Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY L HALL (EXECUTIVE DIRECTOR)
(256) 332-1631
Entity
Organization
Contact information
Practice address
925 4TH ST NW, RED BAY, AL 35582-3953
(256) 332-1631
(256) 332-4600
Mailing address
PO BOX 970, RUSSELLVILLE, AL 35653-0970
(256) 332-1631
(256) 332-4600
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
AL
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01200308
BLUE CROSS
AL
05
—
630006001
—
AL
Enumeration date
11/28/2006
Last updated
10/07/2010
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