Provider Demographics
NPI:1689084881
Name:CENTRAL ALABAMA AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:CENTRAL ALABAMA AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGITS/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADY
Authorized Official - Middle Name:BOSTICK
Authorized Official - Last Name:RIVES
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:334-872-9711
Mailing Address - Street 1:203 DALLAS AVE
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36701-5744
Mailing Address - Country:US
Mailing Address - Phone:334-872-9711
Mailing Address - Fax:334-526-4111
Practice Address - Street 1:4 OFFICE PARK CIR
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-6538
Practice Address - Country:US
Practice Address - Phone:334-872-9711
Practice Address - Fax:334-872-7574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1127A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty