Provider Demographics
NPI:1588655161
Name:CULLMAN REGIONAL MEDICAL CENTER INC
Entity Type:Organization
Organization Name:CULLMAN REGIONAL MEDICAL CENTER INC
Other - Org Name:CULLMAN REGIONAL MEDICAL CENTER HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-737-2831
Mailing Address - Street 1:1792 AL HIGHWAY 157
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-3622
Mailing Address - Country:US
Mailing Address - Phone:256-737-2831
Mailing Address - Fax:256-737-2829
Practice Address - Street 1:1792 AL HIGHWAY 157
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-3622
Practice Address - Country:US
Practice Address - Phone:256-737-2831
Practice Address - Fax:256-737-2829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALCUL7089AMedicaid
ALCUL7089AMedicaid