Organization Name: | ALABAMA HEALTHCARE ADVANTAGE EAST |
NPI Number: | 1053776773 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TODD W WHITNEY (SECRETARY OF BOD) |
Mailing Address: | 8650 Minnie Brown Rd Ste 224 Montgomery |
State: | AL US |
Postal Code: | 361177433 |
Phone Number: | 3342153985 |
Fax Number: | |
NPI Enumeration Date: | 12/22/2015 |
NPI Last Update Date: | 12/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |