Provider Demographics
NPI:1356511224
Name:SOUTHLAND HEALTH SERVICES OF ALABAMA, INC.
Entity Type:Organization
Organization Name:SOUTHLAND HEALTH SERVICES OF ALABAMA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-247-9560
Mailing Address - Street 1:PO BOX 1497
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:AL
Mailing Address - Zip Code:35592-1497
Mailing Address - Country:US
Mailing Address - Phone:205-695-9800
Mailing Address - Fax:205-695-7677
Practice Address - Street 1:126 EMERGYSTAT LOOP
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:AL
Practice Address - Zip Code:35592-5258
Practice Address - Country:US
Practice Address - Phone:205-695-9945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5693416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport