| |
309 Saint Lukes Dr Montgomery AL 36117-7109 | |
(334) 420-2001 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 309 Saint Lukes Dr, Montgomery, Alabama |
Authorized Official Name and Position | Susie Ann Beal (CFO) |
Authorized Official Contact | 3344205001 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 70365 Montgomery AL 36107-0365 Ph: (334) 420-5038 | 309 Saint Lukes Dr Montgomery AL 36117-7109 Ph: (334) 420-2001 |
NPI Number | 1548538010 |
---|---|
Provider Enumeration Date | 12/12/2011 |
Last Update Date | 11/29/2023 |
Medicare PECOS PAC ID | 1557324811 |
---|---|
Medicare Enrollment ID | O20140131000125 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548538010 | NPI | - | NPPES |
160203 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Your Doctor's Office, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8630 Vaughn Rd, Montgomery, AL 36117 Phone: 334-676-4076 Fax: 334-676-4064 | |
Aikam Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2895 Zelda Rd, Montgomery, AL 36106 Phone: 334-245-5969 | |