Healthcare Provider Details
I. General information
NPI: 1346213881
Provider Name (Legal Business Name): NORTH ALABAMA CARDIOLOGY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/07/2006
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
503 S 5TH ST
GADSDEN AL
35901-5103
US
IV. Provider business mailing address
503 S 5TH ST
GADSDEN AL
35901-5103
US
V. Phone/Fax
- Phone: 256-546-6200
- Fax: 256-546-6250
- Phone: 256-546-6200
- Fax: 256-546-6250
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | 00017905 |
| License Number State | AL |
VIII. Authorized Official
Name: MRS.
LARUE
S
SALSTER
Title or Position: OFFICE MANAGER
Credential: RCS, RVS
Phone: 256-546-6200