# GREATER ALABAMA HEALTH NETWORK

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609104199
- **Authorized official:** MRS. BECKY HENDERSON (PROGRAM DIRECTOR)
- **Authorized official phone:** (205) 345-1905

## Contact information

- **Practice address:** 921 PROFESSIONAL PLZ, TUSCALOOSA, AL 35401-7418
- **Practice address phone:** (205) 345-1905
- **Practice address fax:** (205) 345-2909
- **Mailing address:** 921 PROFESSIONAL PLZ, TUSCALOOSA, AL 35401-7418
- **Mailing address phone:** (205) 345-1905
- **Mailing address fax:** (205) 345-2909

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 11/23/2009
- **Last updated:** 11/23/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 580500004 | — | AL |