Healthcare Provider Details
I. General information
NPI: 1053855122
Provider Name (Legal Business Name): PATHWAY HEALTHCARE ALABAMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/08/2016
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
48 MEDICAL PARK DR E STE 453
BIRMINGHAM AL
35235-3472
US
IV. Provider business mailing address
48 MEDICAL PARK DR E STE 453
BIRMINGHAM AL
35235-3472
US
V. Phone/Fax
- Phone: 205-517-7730
- Fax: 205-838-5863
- Phone: 205-208-9312
- Fax: 205-848-2227
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATRICK
COMBS
Title or Position: CEO
Credential:
Phone: 205-208-9312