Provider Demographics
NPI:1306304399
Name:LAKELAND COMMUNITY HOSPITAL INC.
Entity type:Organization
Organization Name:LAKELAND COMMUNITY HOSPITAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:POOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-485-7108
Mailing Address - Street 1:42030 HIGHWAY 195 STE E
Mailing Address - Street 2:
Mailing Address - City:HALEYVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35565-7054
Mailing Address - Country:US
Mailing Address - Phone:205-485-7188
Mailing Address - Fax:
Practice Address - Street 1:42030 HIGHWAY 195 STE E
Practice Address - Street 2:
Practice Address - City:HALEYVILLE
Practice Address - State:AL
Practice Address - Zip Code:35565-7054
Practice Address - Country:US
Practice Address - Phone:205-485-7188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAKELAND COMMUNITY HOSPITAL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care