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NPI Code Detail

MEDICARE: NORTHEAST ALABAMA HEALTH SERVICES, INC.

MEDICARE: NORTHEAST ALABAMA HEALTH SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3D515OTHERALSTATE MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1010969OTHERALBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457418659
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHEAST ALABAMA HEALTH SERVICES, INC.
Provider Business Mailing Address
First Line : 60 MAIN ST N
Second Line :
City : SECTION
State : AL
Zip : 35771-7168
Country : US
Telephone Number : 256-228-3471
Fax Number : 256-228-7289
Provider Business Practice Location Address
First Line : 60 MAIN ST N
Second Line :
City : SECTION
State : AL
Zip : 35771-7168
Country : US
Telephone Number : 256-228-3471
Fax Number : 256-228-7289
Authorized Official
Title or Position : CEO
Name : JAMES P ALLEN JR.
Credential :
Telephone Number : 256-259-5313
Provider Enumeration Date : 01/03/2007
Last Update Date : 05/28/2024

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Directions to “NORTHEAST ALABAMA HEALTH SERVICES, INC. ” Practice Location

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