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Contact Information

COOSA VALLEY UROLOGY, P.C.
16 SOUTH DOUGLAS AVENUE
SYLACAUGA, AL35150
 Phone: 256-245-2269
 Fax: 256-245-2260
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for COOSA VALLEY UROLOGY, P.C.

NPI Number 1083831804
LBN Legal business name COOSA VALLEY UROLOGY, P.C.
Authorized official MAMOUN PACHA - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/20/2007
Last updated 10/04/2013 - About 13 years ago
Identifiers
AL License # 8767
AL Medicaid 529603840
AL Other 340007817 RAILROAD MEDICARE
AL Other 1910002 UNITED HEALTH CARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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