Organization Name: | CAHABA MEDICAL CARE FOUNDATION |
NPI Number: | 1093058133 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN BRYAN WAITS (CEO) |
Mailing Address: | 294 Pierson Avenue Centreville |
State: | AL US |
Postal Code: | 35042 |
Phone Number: | 2059262992 |
Fax Number: | 2059262993 |
NPI Enumeration Date: | 03/27/2013 |
NPI Last Update Date: | 03/27/2013 |
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: |