Provider Demographics
NPI:1467597146
Name:WEDOWEE HOSPITAL
Entity Type:Organization
Organization Name:WEDOWEE HOSPITAL
Other - Org Name:WADLEY CORNERSTONE FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FARRELL
Authorized Official - Middle Name:A
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-357-2111
Mailing Address - Street 1:203 TALLAPOOSA STREET
Mailing Address - Street 2:
Mailing Address - City:WADLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36276
Mailing Address - Country:US
Mailing Address - Phone:256-395-4157
Mailing Address - Fax:256-395-6055
Practice Address - Street 1:203 TALLAPOOSA STREET
Practice Address - Street 2:
Practice Address - City:WADLEY
Practice Address - State:AL
Practice Address - Zip Code:36276
Practice Address - Country:US
Practice Address - Phone:256-395-4157
Practice Address - Fax:256-395-6055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEDOWEE HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-21
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01-3937Medicare ID - Type UnspecifiedRHC