NPIMap

Organization Active NPI

Southeast Alabama Rural Health Associates

Doing business as Slocomb Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Slocomb, AL
National Provider Identifier
1023290608
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES
Doing business as
Slocomb Family Health Center
Practice address
162 S Dalton St
Slocomb, AL 36375-5669
Phone
(334) 886-3023
Fax
(334) 886-3028
NPI assigned
Dec 5, 2007
Last updated
Sep 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Pamylon Bowers
Title
Chief Executive Officer
Phone
(334) 670-6726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

162 S Dalton St
Slocomb, AL 36375-5669

Mailing address

1414 Elba Hwy
Troy, AL 36079-6020
Phone (334) 670-6726

Other identifiers 1

IdentifierTypeStateIssuer
630007018MedicaidAL

Other names 1

  • Slocomb Family Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040526001591 AL Part B Supplier - Clinic/Group Practice 8123009057 Receives reassigned benefits from 32 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Troy, AL; Slocomb, AL; Newton, AL; Geneva, AL; Eufaula, AL; Enterprise, AL; Dothan, AL; Clayton, AL…
O20080519000641 AL Part A Provider - Federally Qualified Health Center (FQHC) 8123009057 Practice locations: Slocomb, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023290608. Details of each certification follow.

Federally qualified health center certification: CCN 011955

Legal name
SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES
Doing business as
SLOCOMB FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 4, 2008
Last certification
Nov 4, 2008
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 16, 1984 in AL
Enrollment address
162S Dalton St
Slocomb, AL 36375-5669

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D1077388Slocomb Family Health Center162 South Dalton Street, Slocomb, AL 36375Certificate of waiverJun 21, 2028

National Provider Directory

National Provider Directory

Locations

162 S Dalton St
Slocomb, AL 36375
Phone (334) 886-3023

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHFGBD

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Oveta Carey Individual Corporate Director Jun 22, 2021
Cynthia Pearson Individual Corporate Director Dec 28, 2007
Hank Strother Individual Corporate Director Jun 22, 2021
Regina Tolbert Individual Corporate Director Jun 22, 2021
Lisa Harris Individual Corporate Director Jun 22, 2021
Leticia Andrews Individual Corporate Director Jun 22, 2021
Southeast Alabama Rural Health Associates Organization, Troy, AL Corporation, Non-profit Operational/Managerial Control Jul 25, 2011 100%
Joe Dalton Individual Corporate Director Jun 22, 2021
Pamylon Bowers Individual Corporate DirectorCeo Jun 22, 2021 100%
W-2 Managing EmployeeCeo Jun 22, 2021 100%
Jack Worthington Individual Corporate Director Jun 22, 2021

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Clayton Family Health CenterClayton, AL, CCN 011868 Federally qualified health center Operational/Managerial Control Sep 17, 2025
Abbeville Family Health CenterAbbeville, AL, CCN 011975 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2011
Dothan Family Health CenterDothan, AL, CCN 011808 Federally qualified health center Operational/Managerial Control (100%) Jul 1, 2012
Geneva Family Health CenterGeneva, AL, CCN 011088 Federally qualified health center Operational/Managerial Control (100%) Apr 1, 2021

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1023290608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 ELBA HWY",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360796020",
            "telephone_number": "334-670-6726",
            "fax_number": "334-670-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 S DALTON ST",
            "city": "SLOCOMB",
            "state": "AL",
            "postal_code": "363755669",
            "telephone_number": "334-886-3023",
            "fax_number": "334-886-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "BOWERS",
        "authorized_official_first_name": "PAMYLON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "334-670-6726",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630007018",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Slocomb Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Slocomb Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Slocomb, AL

Sources for this page

Verify at the official NPI Registry.