Provider Demographics
NPI:1578877817
Name:RCHP - FLORENCE LLC
Entity Type:Organization
Organization Name:RCHP - FLORENCE LLC
Other - Org Name:ELIZA COFFEE MEDICAL CENTER - IP PSYCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-844-9849
Mailing Address - Street 1:205 MARENGO ST
Mailing Address - Street 2:ATTN: FACILITY CEO
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-6033
Mailing Address - Country:US
Mailing Address - Phone:256-768-9417
Mailing Address - Fax:256-768-9420
Practice Address - Street 1:205 MARENGO ST
Practice Address - Street 2:ATTN: FACILITY CEO
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-6033
Practice Address - Country:US
Practice Address - Phone:256-768-9417
Practice Address - Fax:256-768-9420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01S006Medicare Oscar/Certification