| Northeast Alabama Health Services, Inc. | |
|
34617 Al Highway 75 Fyffe AL 35971-3488 | |
| (256) 623-5242 | |
| (256) 623-5243 |
| Full Name | Northeast Alabama Health Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 34617 Al Highway 75, Fyffe, Alabama |
| Authorized Official Name and Position | James P Allen (CEO) |
| Authorized Official Contact | 2562595313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Alabama Health Services, Inc. 34617 Al Highway 75 Fyffe AL 35971-3488 Ph: (256) 623-5242 | Northeast Alabama Health Services, Inc. 34617 Al Highway 75 Fyffe AL 35971-3488 Ph: (256) 623-5242 |
| NPI Number | 1104973353 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 05/28/2024 |
| Medicare PECOS PAC ID | 4082522883 |
|---|---|
| Medicare Enrollment ID | O20030124000009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104973353 | NPI | - | NPPES |
| 012340 | Other | AL | BLUE CROSS BLUE SHIELD |
| I990 | Other | AL | STATE MEDICARE |
| 630008003 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |