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53 Mulberry St Frisco City AL 36445-4484 | |
(251) 267-2880 | |
(251) 267-2358 |
Full Name | |
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Speciality | Clinic/Center |
Location | 53 Mulberry St, Frisco City, Alabama |
Authorized Official Name and Position | Charles N/a White (CEO) |
Authorized Official Contact | 2514324117 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 2048 Mobile AL 36652-2048 Ph: (251) 432-4117 | 53 Mulberry St Frisco City AL 36445-4484 Ph: (251) 267-2880 |
NPI Number | 1982024402 |
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Provider Enumeration Date | 04/23/2014 |
Last Update Date | 08/16/2023 |
Certification Date | 08/16/2023 |
Medicare PECOS PAC ID | 1658356308 |
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Medicare Enrollment ID | O20140625002178 |
Identifier | Type | State | Issuer |
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1982024402 | NPI | - | NPPES |