Provider Demographics
NPI:1114999406
Name:NATIONAL HEALTHCARE OF CULLMAN, INC.
Entity Type:Organization
Organization Name:NATIONAL HEALTHCARE OF CULLMAN, INC.
Other - Org Name:WOODLAND MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:S
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:COFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-764-3009
Mailing Address - Street 1:501 CORPORATE CENTRE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2662
Mailing Address - Country:US
Mailing Address - Phone:615-764-3009
Mailing Address - Fax:615-764-3030
Practice Address - Street 1:1910 CHEROKEE AVE SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5502
Practice Address - Country:US
Practice Address - Phone:256-739-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL HEALTHCARE OF CULLMAN, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-02
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10338273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALHOS0143HMedicaid
ALHOS0143HMedicaid
AL01S143Medicare Oscar/Certification