Provider Demographics
NPI:1447210844
Name:PAINSOUTH, INC.
Entity Type:Organization
Organization Name:PAINSOUTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:COSGROVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-266-3235
Mailing Address - Street 1:5184 CALDWELL MILL RD STE 204-334
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1912
Mailing Address - Country:US
Mailing Address - Phone:205-266-3235
Mailing Address - Fax:205-297-9804
Practice Address - Street 1:5184 CALDWELL MILL RD STE 204-334
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1912
Practice Address - Country:US
Practice Address - Phone:205-266-3235
Practice Address - Fax:205-297-9804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208VP0014X
AL19927208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529804180Medicaid
AL529804180Medicaid
ALI591Medicare PIN