Provider Demographics
NPI:1497017925
Name:NORTHEAST ALABAMA PATHOLOGY, LLC
Entity Type:Organization
Organization Name:NORTHEAST ALABAMA PATHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-235-5271
Mailing Address - Street 1:PO BOX 968
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-0968
Mailing Address - Country:US
Mailing Address - Phone:256-235-5271
Mailing Address - Fax:256-238-0555
Practice Address - Street 1:171 TOWN CENTER DR
Practice Address - Street 2:SUITE M-1B
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36205-4102
Practice Address - Country:US
Practice Address - Phone:256-241-2276
Practice Address - Fax:256-238-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALTAX IDOther