Provider Demographics
NPI:1295273753
Name:GONOW ALABAMA MANAGEMENT LLC
Entity type:Organization
Organization Name:GONOW ALABAMA MANAGEMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-603-2284
Mailing Address - Street 1:PO BOX 490
Mailing Address - Street 2:
Mailing Address - City:FULTONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35068-0490
Mailing Address - Country:US
Mailing Address - Phone:205-515-0538
Mailing Address - Fax:205-544-3072
Practice Address - Street 1:3029 ALLISON BONNETT MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HUEYTOWN
Practice Address - State:AL
Practice Address - Zip Code:35023-2467
Practice Address - Country:US
Practice Address - Phone:205-436-8270
Practice Address - Fax:205-436-8275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-05
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care