Provider Demographics
NPI:1497838627
Name:HUNTSVILLE NEPHROLOGY ASSOCIATES
Entity Type:Organization
Organization Name:HUNTSVILLE NEPHROLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-532-1888
Mailing Address - Street 1:303 WILLIAMS AVE SW
Mailing Address - Street 2:SUITE 129
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6012
Mailing Address - Country:US
Mailing Address - Phone:256-532-1888
Mailing Address - Fax:256-532-3941
Practice Address - Street 1:201 SIVLEY RD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5134
Practice Address - Country:US
Practice Address - Phone:256-532-1888
Practice Address - Fax:256-532-3941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALD296Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER