Provider Demographics
NPI:1144335241
Name:ANNISTON ONCOLOGY
Entity type:Organization
Organization Name:ANNISTON ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPREMULLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-238-1011
Mailing Address - Street 1:901 LEIGHTON AVE
Mailing Address - Street 2:SUITE 602
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5700
Mailing Address - Country:US
Mailing Address - Phone:256-238-1011
Mailing Address - Fax:256-238-4366
Practice Address - Street 1:901 LEIGHTON AVE
Practice Address - Street 2:SUITE 602
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5700
Practice Address - Country:US
Practice Address - Phone:256-238-1011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00011380207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529501680Medicaid
ALDB7013OtherMEDICARE RAILROAD
ALDB7013OtherMEDICARE RAILROAD
ALI732Medicare PIN