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5947 Highway 269 Parrish AL 35580-3847 | |
(205) 686-5113 | |
(205) 686-5145 |
Full Name | |
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Speciality | Clinic/Center |
Location | 5947 Highway 269, Parrish, Alabama |
Authorized Official Name and Position | Foster David Jones (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2056865113 |
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 169 Parrish AL 35580-0169 Ph: (205) 686-5113 | 5947 Highway 269 Parrish AL 35580-3847 Ph: (205) 686-5113 |
NPI Number | 1821043837 |
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Provider Enumeration Date | 05/24/2006 |
Last Update Date | 08/23/2023 |
Medicare PECOS PAC ID | 7719990316 |
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Medicare Enrollment ID | O20060727000279 |
Identifier | Type | State | Issuer |
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1821043837 | NPI | - | NPPES |
630000026 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |