National Provider Identifier Database

MIZELL MEMORIAL HOSPITAL INC
Rural


Contact Information

MIZELL MEMORIAL HOSPITAL, INC.
702 N MAIN ST
OPP, AL36467-1626
Phone: 334-493-3541
Fax: 334-493-9433
Website:
Specialty Taxonomy Code
* Rural 282NR1301X
Lithotripsy 261QL0400X
Medicare Defined Swing Bed Unit 275N00000X
Psychiatric Unit 273R00000X

* Indicates primary specialty

NPI Profile & details for MIZELL MEMORIAL HOSPITAL, INC.

NPI Number 1013937705
Legal business name
LBN
MIZELL MEMORIAL HOSPITAL, INC.
Authorized official JANA WYATT - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart No
Enumeration date 07/19/2006
Last updated 12/24/2019 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • AL License #: 11789
  • AL Medicaid: HOS0007H
  • AL Other: 010095 BLUE CROSS BLUE SHIELD

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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