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COOSA VALLEY UROLOGY, P.C.
NPI 1083831804
Specialist in Sylacauga, AL

Active since April 20, 2007CLIA 01D0300393 · Waiver
16 SOUTH DOUGLAS AVENUE, SYLACAUGA, AL 35150(256) 245-2269(256) 245-2260 Get Directions Write a Review

NPPES record last updated: October 4, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Coosa Valley Urology, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COOSA VALLEY UROLOGY, P.C. (NPI 1083831804) is a healthcare organization registered as a specialist in Sylacauga, Alabama and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through August 3, 2027 and lists Mamoun R Pacha, Owner, as its authorized official.

NPPES Registry Identity

NPI1083831804
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameCOOSA VALLEY UROLOGY, P.C.
Location Address16 SOUTH DOUGLAS AVENUESylacauga, AL 35150
Mailing Address16 South Douglas AvenueSylacauga, AL 35150 · (256) 245-2269 · Fax (256) 245-2260
Phone(256) 245-2269
Fax(256) 245-2260
Organization SubpartNo
Authorized OfficialMamoun R PachaOwner · (256) 245-2269
Enumeration DateApril 20, 2007
Last NPPES UpdateOctober 4, 2013
✔ NPI 1083831804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in AL · 8767
Definition

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.

16 SOUTH DOUGLAS AVENUE, Sylacauga, AL 35150
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Other Identifiers 6

Medicare PIN000005604AL
Other340007817AL · Railroad Medicare
Medicaid529603840AL
Medicare NSC0522500001AL
Other1910002AL · United Health Care
Medicare UPINC76484AL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 01D0300393

Coosa Valley Urology · Sylacauga, AL
Active · expires Aug 3, 2027
CLIA Number01D0300393
Laboratory TypePhysician Office
Certificate Effective DateAugust 4, 2025
Certificate Expiration DateAugust 3, 2027
Laboratory DirectorMamoun R. Pacha
Laboratory Phone(256) 245-2269
Laboratory LocationCoosa Valley Urology16 South Douglas Avenue, Sylacauga, AL 35150
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Coosa Valley Urology, P.C.'s NPI number?

The NPI number for Coosa Valley Urology, P.C. is 1083831804. It was assigned to this organization in the NPPES registry on April 20, 2007.

Where is Coosa Valley Urology, P.C. located?

Coosa Valley Urology, P.C. is located at 16 South Douglas Avenue, Sylacauga, AL 35150. The listed phone number is (256) 245-2269.

What is Coosa Valley Urology, P.C.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Coosa Valley Urology, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D0300393) is associated with this NPI, valid through August 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Coosa Valley Urology, P.C. was last updated on October 4, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.