| Tri County Medical Center Inc | |
|
316 S Main St Evergreen AL 36401-3325 | |
| (251) 578-1163 | |
| Not Available |
| Full Name | Tri County Medical Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 316 S Main St, Evergreen, Alabama |
| Authorized Official Name and Position | Marilyn J Sawyer (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2515781163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri County Medical Center Inc Po Box 726 316 South Main Street Evergreen AL 36401-0726 Ph: (251) 578-1163 | Tri County Medical Center Inc 316 S Main St Evergreen AL 36401-3325 Ph: (251) 578-1163 |
| NPI Number | 1679658371 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 04/28/2008 |
| Medicare PECOS PAC ID | 2567371255 |
|---|---|
| Medicare Enrollment ID | O20040124000384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679658371 | NPI | - | NPPES |
| 630000017 | Medicaid | AL | |
| CD9346 | Other | AL | RAILROAD MEDICARE GROUP |
| DD4470 | Other | AL | RAILROAD MEDICAID GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | William D Talley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053523456 PECOS PAC ID: 9739331737 Enrollment ID: I20121219000442 |
Evergreen Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Edwina Street, Evergreen, AL 36401 Phone: 251-578-3331 Fax: 251-578-2006 |