Provider Demographics
NPI:1003825696
Name:DOWNEY MEDICAL INC
Entity Type:Organization
Organization Name:DOWNEY MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RHPH
Authorized Official - Phone:256-238-8991
Mailing Address - Street 1:317 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5707
Mailing Address - Country:US
Mailing Address - Phone:256-238-8991
Mailing Address - Fax:256-236-6274
Practice Address - Street 1:317 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5707
Practice Address - Country:US
Practice Address - Phone:256-238-8991
Practice Address - Fax:256-236-6274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2098332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000050136Medicaid
AL51050136OtherBLUE CROSS BLUE SHIELD
AL51050136OtherBLUE CROSS BLUE SHIELD