Provider Demographics
NPI:1902910276
Name:PICKENS COUNTY MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:PICKENS COUNTY MEDICAL CENTER, INC.
Other - Org Name:HOME COMFORT MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-367-1234
Mailing Address - Street 1:PO BOX 478
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:AL
Mailing Address - Zip Code:35447-0478
Mailing Address - Country:US
Mailing Address - Phone:205-367-1234
Mailing Address - Fax:205-367-2110
Practice Address - Street 1:96 COURT SQUARE
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:AL
Practice Address - Zip Code:35447
Practice Address - Country:US
Practice Address - Phone:205-367-1234
Practice Address - Fax:205-367-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL143207332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009603260Medicaid
AL510-33632OtherBLUECROSS BLUESHIELD
AL510-33632OtherBLUECROSS BLUESHIELD