Provider Demographics
NPI:1427217975
Name:COOSA VALLEY EQUINE CENTER, P. C.
Entity Type:Organization
Organization Name:COOSA VALLEY EQUINE CENTER, P. C.
Other - Org Name:COOSA VALLEY EQUINE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:FOUST
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DVM
Authorized Official - Phone:205-338-1111
Mailing Address - Street 1:1330 MINERAL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-3424
Mailing Address - Country:US
Mailing Address - Phone:205-338-1111
Mailing Address - Fax:205-338-3242
Practice Address - Street 1:1330 MINERAL SPRINGS RD
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-3424
Practice Address - Country:US
Practice Address - Phone:205-338-1111
Practice Address - Fax:205-338-3242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2327174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2327OtherSTATE LICENSE#
AL2327OtherSTATE LICENSE#