Provider Demographics
NPI:1588871842
Name:VILLAGE HEALTH ASSOCIATES LLC
Entity type:Organization
Organization Name:VILLAGE HEALTH ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-622-0333
Mailing Address - Street 1:2543 COUNTY ROAD 651
Mailing Address - Street 2:
Mailing Address - City:CHANCELLOR
Mailing Address - State:AL
Mailing Address - Zip Code:36316-7011
Mailing Address - Country:US
Mailing Address - Phone:850-622-0333
Mailing Address - Fax:
Practice Address - Street 1:2543 COUNTY ROAD 651
Practice Address - Street 2:
Practice Address - City:CHANCELLOR
Practice Address - State:AL
Practice Address - Zip Code:36316-7011
Practice Address - Country:US
Practice Address - Phone:850-622-0333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AF176Medicare PIN