Provider Demographics
NPI:1154690204
Name:HUNTSVILLE PAIN MANAGEMENT, INC.
Entity Type:Organization
Organization Name:HUNTSVILLE PAIN MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:THACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-885-1605
Mailing Address - Street 1:185 CHATEAU DR SW
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-7416
Mailing Address - Country:US
Mailing Address - Phone:256-885-1605
Mailing Address - Fax:256-885-1905
Practice Address - Street 1:185 CHATEAU DR SW
Practice Address - Street 2:SUITE 302
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-7416
Practice Address - Country:US
Practice Address - Phone:256-885-1605
Practice Address - Fax:256-885-1905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain