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801 University Blvd S Ste D Mobile AL 36609-2949 | |
| (251) 344-1964 | |
| (251) 344-2227 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 801 University Blvd S Ste D, Mobile, Alabama |
| Authorized Official Name and Position | Charles White (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2514324117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2048 Mobile AL 36652-2048 Ph: (251) 432-4117 | 801 University Blvd S Ste D Mobile AL 36609-2949 Ph: (251) 344-1964 |
| NPI Number | 1154551703 |
|---|---|
| Provider Enumeration Date | 07/16/2009 |
| Last Update Date | 08/30/2022 |
| Medicare PECOS PAC ID | 1658356308 |
|---|---|
| Medicare Enrollment ID | O20091231000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154551703 | NPI | - | NPPES |
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