Organization Name: | SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES |
NPI Number: | 1023290608 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN A LITTLE (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 162 S Dalton St Slocomb |
State: | AL US |
Postal Code: | 363755669 |
Phone Number: | 3348863023 |
Fax Number: | 3348863028 |
NPI Enumeration Date: | 12/05/2007 |
NPI Last Update Date: | 02/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |