Provider Demographics
NPI:1407891336
Name:CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLETON
Authorized Official - Middle Name:
Authorized Official - Last Name:PYFROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-534-8659
Mailing Address - Street 1:110 WALKER AVE NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4739
Mailing Address - Country:US
Mailing Address - Phone:256-534-8659
Mailing Address - Fax:256-533-0276
Practice Address - Street 1:751 PLEASANT ROW NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-2537
Practice Address - Country:US
Practice Address - Phone:256-534-8659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALCE7533OtherRAILROAD MEDICARE PART B
ALCE7533OtherRAILROAD MEDICARE PART B
ALF69587Medicare UPIN
ALE90659Medicare UPIN
ALF67202Medicare UPIN
ALG08686Medicare UPIN
ALH36522Medicare UPIN
ALH71488Medicare UPIN
ALE33533Medicare UPIN
ALC19628Medicare UPIN
ALP86887Medicare UPIN
ALH16436Medicare UPIN
ALF70428Medicare UPIN
AL011838Medicare ID - Type UnspecifiedFQHC
ALC73634Medicare UPIN
AL011838Medicare Oscar/Certification