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410 Sutton Rd Se Hampton Cove AL 35763-9164 | |
(256) 424-4260 | |
(256) 424-4264 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 410 Sutton Rd Se, Hampton Cove, Alabama |
Authorized Official Name and Position | Randy Johansen (PRESIDENT) |
Authorized Official Contact | 2054212102 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3700 Cahaba Beach Rd Birmingham AL 35242-5225 Ph: (205) 403-8902 | 410 Sutton Rd Se Hampton Cove AL 35763-9164 Ph: (256) 424-4260 |
NPI Number | 1013224443 |
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Provider Enumeration Date | 09/07/2010 |
Last Update Date | 04/09/2024 |
Identifier | Type | State | Issuer |
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1013224443 | NPI | - | NPPES |
529202590 | Medicaid | AL |