Provider Demographics
NPI:1962870477
Name:CENTRAL ALABAMA MEDICAL CONTRACTORS, INC
Entity type:Organization
Organization Name:CENTRAL ALABAMA MEDICAL CONTRACTORS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:WOOLDRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-300-4460
Mailing Address - Street 1:101 KELLEY BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:AL
Mailing Address - Zip Code:36054-2221
Mailing Address - Country:US
Mailing Address - Phone:334-245-2600
Mailing Address - Fax:334-245-2610
Practice Address - Street 1:101 KELLEY BLVD STE D
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:AL
Practice Address - Zip Code:36054-2221
Practice Address - Country:US
Practice Address - Phone:334-245-2600
Practice Address - Fax:334-245-2610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
AL17565261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care