Provider Demographics
NPI:1285710061
Name:LINDEN HOSPITAL BOARD
Entity type:Organization
Organization Name:LINDEN HOSPITAL BOARD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:C
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:334-295-8631
Mailing Address - Street 1:608 N MAIN ST
Mailing Address - Street 2:PO BOX 480938
Mailing Address - City:LINDEN
Mailing Address - State:AL
Mailing Address - Zip Code:36748-1221
Mailing Address - Country:US
Mailing Address - Phone:334-295-8631
Mailing Address - Fax:334-295-0117
Practice Address - Street 1:608 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:AL
Practice Address - Zip Code:36748-1221
Practice Address - Country:US
Practice Address - Phone:334-295-8631
Practice Address - Fax:334-295-0117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12618314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL015330Medicare Oscar/Certification
AL0759800001Medicare NSC
AL015330Medicare PIN