Chatom Primary Care Pc | |
14634 Saint Stephens Ave Chatom AL 36518-6711 | |
(251) 847-6262 | |
(251) 847-6277 |
Full Name | Chatom Primary Care Pc |
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Speciality | Clinic/Center |
Location | 14634 Saint Stephens Ave, Chatom, Alabama |
Authorized Official Name and Position | James Steven Donald (OWNER PRESIDENT) |
Authorized Official Contact | 2518476262 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Chatom Primary Care Pc Po Box 1237 Chatom AL 36518 Ph: (251) 847-6262 | Chatom Primary Care Pc 14634 Saint Stephens Ave Chatom AL 36518-6711 Ph: (251) 847-6262 |
NPI Number | 1730158544 |
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Provider Enumeration Date | 03/15/2006 |
Last Update Date | 02/24/2016 |
Medicare PECOS PAC ID | 9537187380 |
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Medicare Enrollment ID | O20051109001188 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730158544 | NPI | - | NPPES |
529905180 | Medicaid | AL | |
541003923 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | James S Donald |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558339234 PECOS PAC ID: 9537269303 Enrollment ID: I20101028000613 |
Provider Name | Glenda F Ganus |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699775643 PECOS PAC ID: 5991882359 Enrollment ID: I20141119000465 |
Provider Name | Tonya E Anderson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750794723 PECOS PAC ID: 3971821125 Enrollment ID: I20150420000301 |
Provider Name | Meagan Elizabeth Carpenter |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1538553607 PECOS PAC ID: 3476832676 Enrollment ID: I20190823002553 |
Provider Name | Catherine Towns Turner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386207256 PECOS PAC ID: 9537570098 Enrollment ID: I20201204001896 |
Provider Name | Braeden Harding Turner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881368173 PECOS PAC ID: 2264820505 Enrollment ID: I20211019002607 |
Washington County Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14634 St Stephens Ave, Chatom, AL 36518 Phone: 251-847-2223 Fax: 251-847-3808 |