Provider Demographics
NPI:1528002391
Name:FAMILY HEALTH ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:FAMILY HEALTH ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BONITA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:POSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-385-2017
Mailing Address - Street 1:801 20TH AVE E
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-4070
Mailing Address - Country:US
Mailing Address - Phone:205-384-9004
Mailing Address - Fax:205-385-2040
Practice Address - Street 1:801 20TH AVE E
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-4070
Practice Address - Country:US
Practice Address - Phone:205-384-9004
Practice Address - Fax:205-385-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529201200Medicaid
ALD950Medicare PIN