Provider Demographics
NPI:1083279798
Name:THE CAPSTONE RURAL HEALTH CENTER
Entity Type:Organization
Organization Name:THE CAPSTONE RURAL HEALTH CENTER
Other - Org Name:CAPSTONE ARLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FOSTER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:205-686-5113
Mailing Address - Street 1:PO BOX 169
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:AL
Mailing Address - Zip Code:35580-0169
Mailing Address - Country:US
Mailing Address - Phone:205-686-5113
Mailing Address - Fax:205-686-5145
Practice Address - Street 1:6638 COUNTY ROAD 41
Practice Address - Street 2:
Practice Address - City:ARLEY
Practice Address - State:AL
Practice Address - Zip Code:35541
Practice Address - Country:US
Practice Address - Phone:205-686-5113
Practice Address - Fax:205-686-5145
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CAPSTONE RURAL HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-08
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty