Provider Demographics
NPI:1750607339
Name:CENTRAL ALABAMA COMPREHENSIVE HEALTH INCORPORATED
Entity type:Organization
Organization Name:CENTRAL ALABAMA COMPREHENSIVE HEALTH INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-727-7050
Mailing Address - Street 1:203 W LEE ST
Mailing Address - Street 2:
Mailing Address - City:TUSKEGEE
Mailing Address - State:AL
Mailing Address - Zip Code:36083-1719
Mailing Address - Country:US
Mailing Address - Phone:334-727-7636
Mailing Address - Fax:334-727-7657
Practice Address - Street 1:203 W LEE ST
Practice Address - Street 2:
Practice Address - City:TUSKEGEE
Practice Address - State:AL
Practice Address - Zip Code:36083-1719
Practice Address - Country:US
Practice Address - Phone:334-727-7636
Practice Address - Fax:334-727-7657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1133523336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0136487OtherNCPDP PROVIDER IDENTIFICATION NUMBER