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SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES NPI 1063573301

NPI Profile

NPI: 1063573301
Provider Name: SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES

Doing Business As: DOZIER FAMILY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 01D0674455

Address:
18131 DOZIER HWY
DOZIER, AL
ZIP 36028
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Phone: (334) 496-3521

SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES is a federally qualified health center (fqhc) clinic center in Dozier, AL. SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES NPI is 1063573301. The provider is registered as an organization entity type.
The provider Is Doing Business As Dozier Family Health Center.

The provider's business location address is:

18131 DOZIER HWY
DOZIER, AL
ZIP 36028-100
Phone: (334) 496-3521
Fax: (334) 496-3648

The provider's authorized official is John A Little .
The authorized official title is Ceo and has the following contact phone number (334) 670-6726.

The CLIA number assigned to this NPI record is 01D0674455 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/12/2006 and was last updated on 2/3/2012.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1630003018MEDICAIDALABAMA
2011866MEDICARE OSCAR/CERTIFICATIONALABAMA

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: 11/24/2020

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