Provider Demographics
NPI:1245226489
Name:ALABAMA FAMILY MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:ALABAMA FAMILY MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:B
Authorized Official - Last Name:PERAMSETTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-553-1900
Mailing Address - Street 1:1718 VETERANS MEMORIAL PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-4708
Mailing Address - Country:US
Mailing Address - Phone:205-553-1900
Mailing Address - Fax:205-553-4575
Practice Address - Street 1:1718 VETERANS MEMORIAL PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404
Practice Address - Country:US
Practice Address - Phone:205-553-1900
Practice Address - Fax:205-553-4575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24373101YM0800X
AL21446207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty