Provider Demographics
NPI:1053079624
Name:ATTENTUS MOULTON, LLC
Entity Type:Organization
Organization Name:ATTENTUS MOULTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:256-974-2286
Mailing Address - Street 1:202 HOSPITAL STREET
Mailing Address - Street 2:
Mailing Address - City:MOULTON
Mailing Address - State:AL
Mailing Address - Zip Code:35650
Mailing Address - Country:US
Mailing Address - Phone:256-974-2254
Mailing Address - Fax:256-974-2240
Practice Address - Street 1:202 HOSPITAL STREET
Practice Address - Street 2:
Practice Address - City:MOULTON
Practice Address - State:AL
Practice Address - Zip Code:35650
Practice Address - Country:US
Practice Address - Phone:256-974-2254
Practice Address - Fax:256-974-2240
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATTENTUS MOULTON, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH050059HMedicaid