COOSA VALLEY UROLOGY, P.C. (NPI# 1083831804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083831804 |
| Entity Type | Organization |
| Organization Name | COOSA VALLEY UROLOGY, P.C. |
| Practice Address |
16 South Douglas Avenue Sylacauga AL 35150 |
| Practice Telephone | 2562452269 |
| Practice Fax Number | 2562452260 |
| Mailing Telephone | 2562452269 |
| Mailing Fax Number | 2562452260 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2013-10-04 |
| Authorized Official Name | DR. MAMOUN R PACHA (OWNER) |
| Authorized Official Telephone | 2562452269 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 8767 | AL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | RAILROAD MEDICARE | 340007817 | 01 |
| AL | UNITED HEALTH CARE | 1910002 | 01 |
| AL | 529603840 | 05 |
| Street Address |
16 SOUTH DOUGLAS AVENUE |
| City | SYLACAUGA |
| State | AL |
| Zip Code | 35150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245830934 | Casey Delane Sumner | Pharmacist | 1930 Pleasant Ridge Loop, Sylacauga, AL 35150 | 2020-10-30 |
| 1043870231 | Rehab and Wellness Clinic, LLC | Pain Medicine | 234 North Broadway, Sylacauga, AL 35150 | 2019-06-19 |
| 1366999195 | Tasia Bates Bradford | Nurse Practitioner | 209 W Spring St Ste 102, Sylacauga, AL 35150 | 2016-09-09 |
| 1689720641 | John Sidney Mcpeters | Dentist | 1604 Talladega Hwy, Dr John S Mcpeters, Sylacauga, AL 35150 | 2007-01-25 |
| 1972652386 | David Paul Currie | Dentist | 499 W 3rd St, Sylacauga, AL 35150 | 2007-01-09 |
| 1336221647 | Thomas M Kines | Optometrist | 493 W 3rd Street, Sylacauga, AL 35150 | 2006-10-19 |
| 1275623639 | Charles E. Singleton | Surgery | 208 West Spring Street, Suite 300, Sylacauga, AL 35150 | 2006-10-13 |
| 1881794410 | Said Y Salman | Durable Medical Equipment & Medical Supplies | 122 N Broadway Ave, Sylacauga, AL 35150 | 2006-09-24 |
| 1952416141 | Bruno's Supermarkets, LLC. | Durable Medical Equipment & Medical Supplies | 1301 West Ft Williams, Sylacauga, AL 35150 | 2006-08-20 |
| 1508818444 | Thaddeus Frazell Coleman | Radiology | 113 West Clay Street, Sylacauga, AL 35150 | 2006-05-17 |
| Find all providers in zip 35150 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912447210 | Neal Laye | Specialist | 29 W 3rd St, Suite B, Sylacauga, AL 35150-2480 | 2017-03-06 |
| 1609116938 | Lung Care &, P.C. | Specialist | 315 W Fort Williams St, Suite 200, Sylacauga, AL 35150-2433 | 2013-02-23 |
| 1902880768 | Rekha Chadalawada | Specialist | 115 W Clay St, Sylacauga, AL 35150-3413 | 2005-12-05 |
| 1871586453 | Mamoun R Pacha | Specialist | 16 S Douglas Ave, Sylacauga, AL 35150-2951 | 2005-08-29 |
| 1043215114 | Sandra B Martin | Specialist | 315 W Hickory St, Sylacauga, AL 35150-2913 | 2005-06-16 |
| 1093943524 | Gary T. Turner, M.d., P.C. | Specialist | 13 Western Ave, Sylacauga, AL 35150-2939 | 2009-06-23 |
| 1023280716 | Charles Brentnall, M.d., P.a. | Specialist | 7 Brown Ave, Sylacauga, AL 35150-2421 | 2008-04-02 |
| 1730270562 | Michael G. Martin, M.d., LLC | Specialist | 209 W Spring St, Suite 302, Sylacauga, AL 35150-2973 | 2006-09-27 |
| 1619952033 | Robert M. Gray | Specialist | 115 W Clay St, Sylacauga, AL 35150-3413 | 2005-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745571 | Rachel Kestler | Specialist | 4102 Gadiator Street, Fort Rucker, AL 36362 | 2020-09-22 |
| 1528699444 | Jackson Hospital and Clinic, Inc | Specialist | 321 Greenville Byp Ste 2, Greenville, AL 36037-3757 | 2020-01-29 |
| 1548809403 | Mizell Memorial Hospital, Inc. | Specialist | 103 E Memorial Ave Ste A, Opp, AL 36467-1746 | 2019-12-24 |
| 1013564285 | Octavia Elisa Bruce | Specialist | 808 Green Springs Hwy, Suite 124 Studio 4, Homewood, AL 35216 | 2019-08-22 |
| 1407417702 | Sasha J White | Specialist | 410 Governors Dr. Sw, Huntsville, AL 35801 | 2019-06-26 |
| 1609342088 | Vituro Health of Georgia, LLC | Specialist | 2901 2nd Ave S Ste 130, Birmingham, AL 35233-2928 | 2018-10-23 |
| 1598248205 | Almatriga Vladzetta Essex | Specialist | 1110 15th St Ste G, Tuscaloosa, AL 35401-3393 | 2018-09-09 |
| 1013428580 | Larry Dell Turner | Specialist | 600 S Court St Ste 312, Montgomery, AL 36104-4106 | 2017-10-23 |
| 1447789870 | Alexis Lindsey | Specialist | 1909 Commerce Avenue Nw, Cullman, AL 35055 | 2017-06-08 |
| 1356889547 | David Perry | Specialist | 3208 Colony Park Dr, Birmingham, AL 35243-2396 | 2017-02-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.