Provider Demographics
NPI:1295924322
Name:PRIMARY CARE ASSOCIATES OF ALABASTER
Entity type:Organization
Organization Name:PRIMARY CARE ASSOCIATES OF ALABASTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-664-1331
Mailing Address - Street 1:1022 1ST ST N
Mailing Address - Street 2:STE 400
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8706
Mailing Address - Country:US
Mailing Address - Phone:205-664-1331
Mailing Address - Fax:205-664-7584
Practice Address - Street 1:1022 1ST ST N
Practice Address - Street 2:STE 400
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8706
Practice Address - Country:US
Practice Address - Phone:205-664-1331
Practice Address - Fax:205-664-7584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty