Provider Demographics
NPI:1477835825
Name:UNITED FLORALA, INC
Entity Type:Organization
Organization Name:UNITED FLORALA, INC
Other - Org Name:FLORALA MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MISHKA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RABUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-858-3287
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:FLORALA
Mailing Address - State:AL
Mailing Address - Zip Code:36442-0189
Mailing Address - Country:US
Mailing Address - Phone:334-858-3287
Mailing Address - Fax:
Practice Address - Street 1:24273 FIFTH AVENUE
Practice Address - Street 2:
Practice Address - City:FLORALA
Practice Address - State:AL
Practice Address - Zip Code:36442
Practice Address - Country:US
Practice Address - Phone:334-858-3287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01U066Medicare Oscar/Certification