1366478083 NPI number — CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.

Table of content: (NPI 1366478083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366478083 NPI number — CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366478083
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 18488
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTSVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35804-8488
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-534-8659
Provider Business Mailing Address Fax Number:
256-533-0276

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1310 PULASKI PIKE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35816-2528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-539-4457
Provider Business Practice Location Address Fax Number:
256-539-6823
Provider Enumeration Date:
06/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PYFROM
Authorized Official First Name:
CARLETON
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
256-534-8659

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 51530154 . This is a "BLUE CROSS BLUE SHIELDS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51547536 . This is a "BLUE CROSS BLUE SHIELDS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51547535 . This is a "BLUE CROSS BLUE SHIELDS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51547537 . This is a "BLUE CROSS BLUE SHIELDS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51517371 . This is a "BLUE CROSS BLUE SHIELDS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51541456 . This is a "BLUE CROSS BLUE SHIELDS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51531178 . This is a "BLUE CROSS BLUE SHIELDS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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