Provider Demographics
NPI:1134440894
Name:REFORM RURAL HEALTH CENTER PC
Entity type:Organization
Organization Name:REFORM RURAL HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:205-375-6251
Mailing Address - Street 1:PO BOX 670
Mailing Address - Street 2:
Mailing Address - City:REFORM
Mailing Address - State:AL
Mailing Address - Zip Code:35481-0670
Mailing Address - Country:US
Mailing Address - Phone:205-375-6251
Mailing Address - Fax:205-375-6121
Practice Address - Street 1:514 10TH AVE SW
Practice Address - Street 2:
Practice Address - City:REFORM
Practice Address - State:AL
Practice Address - Zip Code:35481
Practice Address - Country:US
Practice Address - Phone:205-375-6251
Practice Address - Fax:205-375-6121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty