Organization
MOUNDVILLE HEALTH AND REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP CODY LONG (CFO)
(205) 391-3600
Entity
Organization
Contact information
Practice address
121 UNION ST, MOUNDVILLE, AL 35474
(205) 371-2252
Mailing address
121 UNION ST, MOUNDVILLE, AL 35474
(205) 371-2252
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012709
BCBS ID
AL
05
—
4754560S
—
AL
Enumeration date
06/07/2006
Last updated
10/01/2020
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