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General NPI Number Information
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NPI Number | 1356498505
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Entity Type | Organization
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Legal Business Name | NORTHEAST ALABAMA HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 29810 AL HIGHWAY 71
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City | BRYANT
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State | AL
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Zip | 35958-5240
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Country | US
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Telephone | 256-597-4114
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Fax | 256-597-4115
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Provider Business Mailing Address
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Address Line | 29810 AL HIGHWAY 71
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City | BRYANT
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State | AL
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Zip | 35958-5240
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Country | US
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Telephone | 256-597-4114
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Fax | 256-597-4115
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Authorized Official
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Title or Position | CEO
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Name | JAMES P ALLEN JR.
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Credential |
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Telephone | 256-259-5313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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