Organization
DALE MEDICAL CENTER
Active
Parent organization
DALE MEDICAL CENTER
Other names
DMC Anesthesia
Organization subpart
Yes
Provider details
NPI number
Legal business name
DALE MEDICAL CENTER
Authorized official
MR. VERNON L. JOHNSON (CEO)
(334) 774-2601
Entity
Organization
Contact information
Practice address
126 HOSPITAL AVE, OZARK, AL 36360-2018
(334) 774-2601
(334) 774-8863
Mailing address
PO BOX 863, OZARK, AL 36361-0863
(334) 443-1211
(334) 443-0131
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529908650
—
AL
01
—
W090
BCBS COMMON PAY NUMBER
AL
Enumeration date
06/15/2007
Last updated
04/11/2018
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