Provider Demographics
NPI:1710640305
Name:CULLMAN REGIONAL MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:CULLMAN REGIONAL MEDICAL CENTER, INC
Other - Org Name:CULLMAN REGIONAL HARTSELLE HEALTH PARK
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-737-2930
Mailing Address - Street 1:PO BOX 1108
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056-1108
Mailing Address - Country:US
Mailing Address - Phone:256-737-2081
Mailing Address - Fax:256-737-5003
Practice Address - Street 1:1549 HIGHWAY 31 NW
Practice Address - Street 2:
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640-4431
Practice Address - Country:US
Practice Address - Phone:256-735-5920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CULLMAN REGIONAL MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-20
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology