Provider Demographics
NPI:1417084971
Name:DECATUR GENERAL HOSPITAL
Entity Type:Organization
Organization Name:DECATUR GENERAL HOSPITAL
Other - Org Name:DECATUR PULMONARY AND SLEEP SPECIALISTS/INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-341-2000
Mailing Address - Street 1:1215 7TH ST SE
Mailing Address - Street 2:SUITE 140/120
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3337
Mailing Address - Country:US
Mailing Address - Phone:256-341-0152
Mailing Address - Fax:256-341-0587
Practice Address - Street 1:1215 7TH ST SE
Practice Address - Street 2:SUITE 140/120
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3337
Practice Address - Country:US
Practice Address - Phone:256-341-0152
Practice Address - Fax:256-341-0587
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DECATUR GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-28
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALQ444OtherBCBS
ALG038OtherBCBS
ALQ444OtherBCBS