Provider Demographics
NPI:1780798108
Name:SOUTHERN HEALTH ASSOCIATES LLC
Entity type:Organization
Organization Name:SOUTHERN HEALTH ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:PEARLSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-566-9800
Mailing Address - Street 1:801 S FRANKLIN DR
Mailing Address - Street 2:P O BOX 1185
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-3838
Mailing Address - Country:US
Mailing Address - Phone:334-566-9800
Mailing Address - Fax:334-566-3700
Practice Address - Street 1:801 S FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-3838
Practice Address - Country:US
Practice Address - Phone:334-566-9800
Practice Address - Fax:334-566-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000046153Medicaid
AL000046154Medicaid
AL511-26794OtherBLUE CROSS PROVIDER
AL000046154OtherDR TODD PEARLSTEIN MEDICARE PROVDIER NUMBER
AL51046154OtherBLUECROSS
AL051551412OtherBLUE CROSS STACIE JONES C
AL51046153OtherDR.PAMELA TRANTHAM
ALCG0951OtherRR MEDICARE GROUP #
AL000046153OtherDR TRANTH AM MEDICARE PROVIDER NUMBER
AL102I082149OtherDR ERIC LAW PTAN MEDICARE NUMBER
AL529903890Medicaid
ALP00213239OtherRR MEDICARE STACIE JONESC
AL891004000Medicaid
AL51046154OtherBLUECROSS
AL51046153OtherDR.PAMELA TRANTHAM
AL102I082149OtherDR ERIC LAW PTAN MEDICARE NUMBER
AL000046153Medicaid