# PATHWAY HEALTHCARE-LOUISIANA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pathway Healthcare LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295391837
- **Authorized official:** MRS. ALICE BYNUM MPH (REVENUE CYCLE MANAGER)
- **Authorized official phone:** (205) 517-7730

## Contact information

- **Practice address:** 1514 JEFFERSON HWY, JEFFERSON, LA 70121-2429
- **Practice address phone:** (205) 517-7730
- **Practice address fax:** (205) 838-5863
- **Mailing address:** PO BOX 1080, TRUSSVILLE, AL 35173-6080
- **Mailing address phone:** (205) 517-7730
- **Mailing address fax:** (205) 838-5863

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/17/2019
- **Last updated:** 06/11/2019