Provider Demographics
NPI:1811394547
Name:ACSH PRIMARY CARE OF ALABAMA, LLC
Entity Type:Organization
Organization Name:ACSH PRIMARY CARE OF ALABAMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WINLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-465-1000
Mailing Address - Street 1:PO BOX 101070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30392-1070
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 W GRAND AVE
Practice Address - Street 2:STE 90
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-3275
Practice Address - Country:US
Practice Address - Phone:256-459-4987
Practice Address - Fax:256-459-4987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty