Organization
CAHABA MEDICAL CARE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BRYAN WAITS M.D. (CEO)
(205) 926-2992
Entity
Organization
Contact information
Practice address
195 HOSPITAL DR, CENTREVILLE, AL 35042-2935
(205) 926-2992
(205) 926-2993
Mailing address
195 HOSPITAL DR, CENTREVILLE, AL 35042-2935
(205) 926-2992
(205) 926-2993
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-1029
MEDICARE PTAN
AL
01
—
01-1030
MEDICARE PTAN
AL
Enumeration date
06/28/2012
Last updated
06/05/2017
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