Provider Demographics
NPI:1891236964
Name:EAST ALABAMA OCCUPATIONAL MEDICINE
Entity type:Organization
Organization Name:EAST ALABAMA OCCUPATIONAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:334-528-1310
Mailing Address - Street 1:2515 E GLENN AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6453
Mailing Address - Country:US
Mailing Address - Phone:334-821-7787
Mailing Address - Fax:334-821-7555
Practice Address - Street 1:2515 E GLENN AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-6453
Practice Address - Country:US
Practice Address - Phone:334-821-7787
Practice Address - Fax:334-821-7555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST ALABAMA MEDICAL DEVELOPMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty