Provider Demographics
NPI:1083937452
Name:NW ALABAMA PRACTICE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:NW ALABAMA PRACTICE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTMORLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-386-4550
Mailing Address - Street 1:PO BOX 895
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-0895
Mailing Address - Country:US
Mailing Address - Phone:256-386-4557
Mailing Address - Fax:
Practice Address - Street 1:1120 S JACKSON HWY
Practice Address - Street 2:SUITE 206
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-5777
Practice Address - Country:US
Practice Address - Phone:256-386-5898
Practice Address - Fax:256-386-5898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLBERT COUNTY NW ALABAMA HEALTHCARE AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-12
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207Q00000X, 207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102G709538Medicare PIN