# CENTERAL ALABAMA VETERANS HEALTH CARE SYSTEM

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

## Provider details

- **NPI number:** 1790889053
- **Authorized official:** MISS TRACEY ELAINE THORNTON RD/LD (CLINICAL DIETITIAN)
- **Authorized official phone:** (334) 272-4670

## Contact information

- **Practice address:** 215 PERRY HILL RD, MONTGOMERY, AL 36109-3725
- **Practice address phone:** (334) 272-4670
- **Practice address fax:** (334) 273-6227
- **Mailing address:** 850 WINGARD ST, PRATTVILLE, AL 36066-5828
- **Mailing address phone:** (334) 365-1030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | 80 | AL | Yes |

## Other

- **Enumeration date:** 09/08/2006
- **Last updated:** 08/22/2020