Provider Demographics
NPI:1093189375
Name:REGIONAL MEDICAL CENTER BOARD
Entity Type:Organization
Organization Name:REGIONAL MEDICAL CENTER BOARD
Other - Org Name:RMC NEUROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:256-235-5252
Mailing Address - Street 1:PO BOX 1380
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-1380
Mailing Address - Country:US
Mailing Address - Phone:256-235-5860
Mailing Address - Fax:256-235-5190
Practice Address - Street 1:901 LEIGHTON AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5700
Practice Address - Country:US
Practice Address - Phone:256-236-1303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL MEDICAL CENTER BOARD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty