Provider Demographics
NPI:1750997706
Name:COMPREHENSIVE PRIMARY & URGENT CARE OF ALABAMA, LLC
Entity type:Organization
Organization Name:COMPREHENSIVE PRIMARY & URGENT CARE OF ALABAMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AUDRA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:256-777-0000
Mailing Address - Street 1:707 W MARKET ST STE C
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2463
Mailing Address - Country:US
Mailing Address - Phone:256-444-1815
Mailing Address - Fax:256-444-0385
Practice Address - Street 1:707 W MARKET ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2463
Practice Address - Country:US
Practice Address - Phone:256-444-1815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty