Provider Demographics
NPI:1811913460
Name:RUSSELL HOSPITAL CORPORATION
Entity type:Organization
Organization Name:RUSSELL HOSPITAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOTHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:PEACE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:256-329-7188
Mailing Address - Street 1:3316 HIGHWAY 280
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-3369
Mailing Address - Country:US
Mailing Address - Phone:256-329-7109
Mailing Address - Fax:256-329-7617
Practice Address - Street 1:3316 HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3369
Practice Address - Country:US
Practice Address - Phone:256-329-7109
Practice Address - Fax:256-329-7617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11873282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04127755Medicaid
AL010046OtherBLUE CROSS OF ALABAMA
AL558200650Medicaid
ALHOS0065HMedicaid
AL558200650Medicaid
MS04127755Medicaid