| Ecd Program, Inc | |
|
808 Downtowner Loop W Mobile AL 36609-5519 | |
| (251) 341-9504 | |
| (251) 341-9509 |
| Full Name | Ecd Program, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 808 Downtowner Loop W, Mobile, Alabama |
| Authorized Official Name and Position | Jemece Emanuel Gasaway (DIRECTOR OF LICENSING) |
| Authorized Official Contact | 2143656126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ecd Program, Inc 5001 Spring Valley Rd Ste 600e Dallas TX 75244-8217 Ph: (214) 365-6100 | Ecd Program, Inc 808 Downtowner Loop W Mobile AL 36609-5519 Ph: (251) 341-9504 |
| NPI Number | 1215434378 |
|---|---|
| Provider Enumeration Date | 04/06/2018 |
| Last Update Date | 06/10/2020 |
| Certification Date | 06/10/2020 |
| Medicare PECOS PAC ID | 7012345200 |
|---|---|
| Medicare Enrollment ID | O20200323001097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215434378 | NPI | - | NPPES |
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