Organization
FORT PAYNE HOSPITAL CORPORATION
Active
Other names
Dekalb Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY MICHAEL COOPER (SVP FINANCE OPERATIONS/AO)
(615) 221-3840
Entity
Organization
Contact information
Practice address
200 MEDICAL CENTER DR SW, FORT PAYNE, AL 35968-3458
(256) 845-3150
(256) 997-2512
Mailing address
PO BOX 277507, ATLANTA, GA 30384-7507
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
012866
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010-109
BCBS
—
05
—
HOS0012H
—
AL
Enumeration date
07/27/2006
Last updated
09/03/2020
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