Provider Demographics
NPI:1396125258
Name:D W MCMILLAN MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:D W MCMILLAN MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-809-8398
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:
Mailing Address - City:CASTLEBERRY
Mailing Address - State:AL
Mailing Address - Zip Code:36432-0397
Mailing Address - Country:US
Mailing Address - Phone:251-966-4600
Mailing Address - Fax:251-966-7433
Practice Address - Street 1:1674 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:CASTLEBERRY
Practice Address - State:AL
Practice Address - Zip Code:36432
Practice Address - Country:US
Practice Address - Phone:251-966-3400
Practice Address - Fax:251-966-7433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17245261QR1300X
AL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health