Custom Family Care | |
279 Hughes Rd Madison AL 35758-1142 | |
(256) 289-1733 | |
Not Available |
Full Name | Custom Family Care |
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Speciality | Family Medicine |
Location | 279 Hughes Rd, Madison, Alabama |
Authorized Official Name and Position | Ivan Pivovarov (PRESIDENT) |
Authorized Official Contact | 2563250480 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Custom Family Care 279 Hughes Rd Madison AL 35758-1142 Ph: () - | Custom Family Care 279 Hughes Rd Madison AL 35758-1142 Ph: (256) 289-1733 |
NPI Number | 1053839811 |
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Provider Enumeration Date | 08/31/2017 |
Last Update Date | 06/02/2021 |
Medicare PECOS PAC ID | 6002171717 |
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Medicare Enrollment ID | O20180530002326 |
Identifier | Type | State | Issuer |
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1053839811 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
Provider Name | Ivan A Pivovarov |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467662148 PECOS PAC ID: 4385712413 Enrollment ID: I20081002000479 |
Provider Name | Dawn Marie Morris |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598464307 PECOS PAC ID: 4082079983 Enrollment ID: I20230428000204 |
Dr. Sunita Puri Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8075 Madison Blvd Ste 106, Madison, AL 35758 Phone: 256-464-6004 Fax: 256-464-0403 | |
Caswall C Harrigan Physician Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Madison Medical Plaza 540 Hughes Road, Suite 14, Madison, AL 35758 Phone: 256-426-0802 | |
Heritage Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12205 County Line Rd, Suite B, Madison, AL 35758 Phone: 256-990-8446 Fax: 256-461-0393 | |
Tennessee Valley Internal Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3809 Sullivan St, Suite 7, Madison, AL 35758 Phone: 256-428-1096 Fax: 256-428-1097 | |
American Family Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7559 Hwy 72 W, Madison, AL 35758 Phone: 256-562-0850 Fax: 256-562-0854 | |
Madison Family Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3776 Sullivan St, Suite D, Madison, AL 35758 Phone: 256-325-0302 Fax: 256-325-0391 |