Healthcare Provider Details

I. General information

NPI: 1437710183
Provider Name (Legal Business Name): CAHABA MEDICAL CARE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 PRINCETON AVE SW
BIRMINGHAM AL
35211-1544
US

IV. Provider business mailing address

405 BELCHER ST
CENTREVILLE AL
35042-2946
US

V. Phone/Fax

Practice location:
  • Phone: 205-340-8108
  • Fax: 205-783-8600
Mailing address:
  • Phone: 205-926-2992
  • Fax: 205-316-7675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAY COX
Title or Position: CCO
Credential:
Phone: 205-277-2384