| Northeast Alabama Health Services Inc - North Sand Mountain | |
|
29810 Al Highway 71 Bryant AL 35958-5240 | |
| (256) 597-4114 | |
| (256) 597-4115 |
| Full Name | Northeast Alabama Health Services Inc - North Sand Mountain |
|---|---|
| Speciality | Clinic/Center |
| Location | 29810 Al Highway 71, Bryant, Alabama |
| Authorized Official Name and Position | James P Allen (CEO) |
| Authorized Official Contact | 2562595313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Alabama Health Services Inc - North Sand Mountain 29810 Al Highway 71 Bryant AL 35958-5240 Ph: (256) 597-4114 | Northeast Alabama Health Services Inc - North Sand Mountain 29810 Al Highway 71 Bryant AL 35958-5240 Ph: (256) 597-4114 |
| NPI Number | 1356498505 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 05/28/2024 |
| Medicare PECOS PAC ID | 4082522883 |
|---|---|
| Medicare Enrollment ID | O20030312000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356498505 | NPI | - | NPPES |
| 630009003 | Medicaid | AL | |
| 012401 | Other | AL | BLUE CROSS BLUE SHIELD |
| J344 | Other | AL | STATE MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |