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4055 Al Highway 9 Cedar Bluff AL 35959-5099 | |
(256) 492-0131 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 4055 Al Highway 9, Cedar Bluff, Alabama |
Authorized Official Name and Position | Wayne Rowe (CEO) |
Authorized Official Contact | 2564920131 |
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 97 Gadsden AL 35902-0097 Ph: (256) 492-0131 | 4055 Al Highway 9 Cedar Bluff AL 35959-5099 Ph: (256) 492-0131 |
NPI Number | 1851676605 |
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Provider Enumeration Date | 10/12/2011 |
Last Update Date | 02/03/2012 |
Medicare PECOS PAC ID | 7810890902 |
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Medicare Enrollment ID | O20111207000315 |
Identifier | Type | State | Issuer |
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1851676605 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |