Provider Demographics
NPI:1255355020
Name:GADSDEN REGIONAL MEDICAL CENTER LLC
Entity type:Organization
Organization Name:GADSDEN REGIONAL MEDICAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-215-3953
Mailing Address - Street 1:PO BOX 404799
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-4799
Mailing Address - Country:US
Mailing Address - Phone:256-494-4585
Mailing Address - Fax:256-494-4474
Practice Address - Street 1:1007 GOODYEAR AVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1195
Practice Address - Country:US
Practice Address - Phone:256-494-4585
Practice Address - Fax:256-494-4474
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GADSDEN REGIONAL MEDICAL CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-26
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALH2801273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALHOS0040HMedicaid
01S040Medicare Oscar/Certification