Island Medical Alabama LLC
Emergency Medicine in Cullman, AL. Organization (NPI-2).
NPI number1104097666
StatusActive
Last updated in NPPESFeb 24, 2023
Details
- NPI
- 1104097666
- Entity type
- Organization (NPI-2)
- Legal business name
- Island Medical Alabama LLC
- Organization subpart
- No
- Enumeration date
- Mar 12, 2008
- Certification date
- Feb 24, 2023
- Last updated
- Feb 24, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | – | AL | Yes |
Practice location
1912 Al Highway 157Cullman, AL 35058-0609
Phone 844-474-4019
Mailing address
4535 Dressler Rd NwCanton, OH 44718-2545
Phone 330-994-4409 · Fax 330-492-8489
Authorized official
Melissa Reese
Provider Enrollment Officer
8556870618
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