Russellville Health Care, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

12541 Issued in AL

Legal business name

RUSSELLVILLE HEALTH CARE, LLC

Practice address

705 Gandy St NE
Russellville, AL 35653-1913

Phone

(256) 332-3773

Fax

(256) 332-1292

NPI assigned

Oct 19, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Brenda Gail Hovater

Title

Nursing Home Administrator

Phone

(256) 332-3773

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Russellville Health Care, Inc. Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1326120502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 GANDY ST NE",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356531913",
            "telephone_number": "256-332-3773",
            "fax_number": "256-332-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 GANDY ST NE",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356531913",
            "telephone_number": "256-332-3773",
            "fax_number": "256-332-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELLVILLE HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "HOVATER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "GAIL",
        "authorized_official_title_or_position": "NURSING HOME ADMINISTRATOR",
        "authorized_official_telephone_number": "256-332-3773",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "12541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4750710",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Russellville Health Care, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Russellville Hospital Inc (Russellville Hospital Medical Clinic)
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• Russellville Hospital Inc (Russellville Hospital Medical Clinic)
• Russellville Hospital Inc. (Russellville Hospital Swing Bed Unit)
• Russellville Hospital Inc. (Russellville Hospital)

• Skilled Nursing Facility in Russellville, AL
• Providers in Russellville, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.