Provider Demographics
NPI:1861833188
Name:HELEN KELLER HOSPITAL OUTPATIENT CLINICS LLC
Entity Type:Organization
Organization Name:HELEN KELLER HOSPITAL OUTPATIENT CLINICS LLC
Other - Org Name:COLBERT COUNTY NORTHWEST ALABAMA HEALTHCARE AUTHORITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:SAM
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-386-4553
Mailing Address - Street 1:1300 S MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-6334
Mailing Address - Country:US
Mailing Address - Phone:256-386-4196
Mailing Address - Fax:
Practice Address - Street 1:202 E DR HICKS BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5768
Practice Address - Country:US
Practice Address - Phone:256-760-0422
Practice Address - Fax:256-760-0332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14483261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center