| Organization Name: | TRIAD OF ALABAMA LLC |
| NPI Number: | 1063464204 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBBIE BREWER (DIRECTOR, PROVIDER ENROLLMENT) |
| Mailing Address: | 314 Macon St Eufaula |
| State: | AL US |
| Postal Code: | 360271810 |
| Phone Number: | 3346877346 |
| Fax Number: | |
| NPI Enumeration Date: | 05/16/2006 |
| NPI Last Update Date: | 04/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QI0500X |
| License Number: | 5082 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Infusion Therapy |
| Taxonomy Definition: | |