Provider Demographics
NPI:1275661704
Name:COMMUNITY HOSPITAL INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPITAL INC
Other - Org Name:COMMUNITY FOOT CARE
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 1:875 FRIENDSHIP RD STE J
Mailing Address - Street 2:
Mailing Address - City:TALLASSEE
Mailing Address - State:AL
Mailing Address - Zip Code:36078-1256
Mailing Address - Country:US
Mailing Address - Phone:334-283-3734
Mailing Address - Fax:
Practice Address - Street 1:875 FRIENDSHIP RD STE J
Practice Address - Street 2:
Practice Address - City:TALLASSEE
Practice Address - State:AL
Practice Address - Zip Code:36078-1256
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:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00242213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC831OtherMEDICARE GROUP PAYOR ID
AL51537650OtherBCBS PROVIDER NUMBER
ALU86926Medicare UPIN