Provider Demographics
NPI:1114919339
Name:CULLMAN REGIONAL MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:CULLMAN REGIONAL MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-737-2000
Mailing Address - Street 1:PO BOX 1108
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056-1108
Mailing Address - Country:US
Mailing Address - Phone:256-737-2000
Mailing Address - Fax:256-737-2005
Practice Address - Street 1:1912 AL HIGHWAY 157
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0609
Practice Address - Country:US
Practice Address - Phone:256-737-2000
Practice Address - Fax:256-737-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALH2201282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL010049OtherBLUE CROSS
ALHOS0035HMedicaid
AL51507378OtherLAB PROVIDER #
AL010049OtherBLUE CROSS
AL51507378OtherLAB PROVIDER #
ALDB8849Medicare PIN
ALC816Medicare PIN
ALHOS0035HMedicaid
AL010035Medicare ID - Type Unspecified