Provider Demographics
NPI:1972869931
Name:CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:CENTRAL NORTH ALABAMA HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLETON
Authorized Official - Middle Name:HA
Authorized Official - Last Name:PYFROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-534-8659
Mailing Address - Street 1:PO BOX 18488
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-8488
Mailing Address - Country:US
Mailing Address - Phone:256-534-8659
Mailing Address - Fax:256-533-0276
Practice Address - Street 1:4208 EVA RD
Practice Address - Street 2:SUITE B
Practice Address - City:EVA
Practice Address - State:AL
Practice Address - Zip Code:35621-7629
Practice Address - Country:US
Practice Address - Phone:256-796-7264
Practice Address - Fax:256-796-2148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207Q00000X
261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty