Provider Demographics
NPI:1164550489
Name:NOTASULGA HEALTHCARE
Entity Type:Organization
Organization Name:NOTASULGA HEALTHCARE
Other - Org Name:COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-283-3734
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:NOTASULGA
Mailing Address - State:AL
Mailing Address - Zip Code:36866-0100
Mailing Address - Country:US
Mailing Address - Phone:334-283-3734
Mailing Address - Fax:
Practice Address - Street 1:56 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:NOTASULGA
Practice Address - State:AL
Practice Address - Zip Code:36866-0100
Practice Address - Country:US
Practice Address - Phone:334-283-3734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-090975363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty