Provider Demographics
NPI:1821150087
Name:REGIONAL HEALTH MANAGEMENT CORPORATION
Entity Type:Organization
Organization Name:REGIONAL HEALTH MANAGEMENT CORPORATION
Other - Org Name:TALLADEGA PRIMARY AND URGENT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-362-1600
Mailing Address - Street 1:803 NORTH ST E
Mailing Address - Street 2:
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35160-2529
Mailing Address - Country:US
Mailing Address - Phone:256-362-1600
Mailing Address - Fax:256-362-8698
Practice Address - Street 1:803 NORTH ST E
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-2529
Practice Address - Country:US
Practice Address - Phone:256-362-1600
Practice Address - Fax:256-362-8698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALD450Medicare ID - Type UnspecifiedLEGACY GROUP NUMBER