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STIDHAM MEDICAL LLC NPI 1679528186


NPI Information

NPI: 1679528186
Provider Name: STIDHAM MEDICAL, LLC

Doing Business As: PINNACLE MOBILE IMAGING, LLC

Classification: Physiological Laboratory - 293D00000X
Entity Type: Organization

CLIA Number: 01D2172534

Address:
1890 AL HIGHWAY 157 STE 220
CULLMAN, AL
ZIP 35058
Phone: (256) 739-1233
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STIDHAM MEDICAL, LLC is a physiological laboratory in Cullman, AL. The provider is a laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. STIDHAM MEDICAL, LLC NPI is 1679528186. The provider is registered as an organization entity type.
The provider Is Doing Business As Pinnacle Mobile Imaging, Llc.

The provider's business location address is:

1890 AL HIGHWAY 157 STE 220
CULLMAN, AL
ZIP 35058-689
Phone: (256) 739-1233
Fax: (256) 734-5129

The provider's authorized official is Jeremy Stidham .
The authorized official title is President/owner and has the following contact phone number (256) 739-1233.

The CLIA number assigned to this NPI record is 01D2172534 - mobile lab with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2006 and was last updated on 3/27/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1293D00000XPhysiological LaboratoryALABAMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000032914MEDICAIDALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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