Provider Demographics
NPI:1255799847
Name:CENTRAL ALABAMA DIAGNOSTICS LLC
Entity type:Organization
Organization Name:CENTRAL ALABAMA DIAGNOSTICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:LEMAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-329-7530
Mailing Address - Street 1:1286 OAK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6929
Mailing Address - Country:US
Mailing Address - Phone:205-329-7519
Mailing Address - Fax:
Practice Address - Street 1:2715 LEGENDS PKWY
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7755
Practice Address - Country:US
Practice Address - Phone:205-329-7530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty