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18131 Dozier Hwy Dozier AL 36028-0100 | |
(334) 496-3521 | |
(334) 496-3648 |
Full Name | |
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Speciality | Clinic/Center |
Location | 18131 Dozier Hwy, Dozier, Alabama |
Authorized Official Name and Position | Pamylon Bowers (CEO) |
Authorized Official Contact | 3346706726 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1414 Elba Hwy Troy AL 36079-6020 Ph: (334) 670-6726 | 18131 Dozier Hwy Dozier AL 36028-0100 Ph: (334) 496-3521 |
NPI Number | 1063573301 |
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Provider Enumeration Date | 12/12/2006 |
Last Update Date | 12/16/2022 |
Medicare PECOS PAC ID | 8123009057 |
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Medicare Enrollment ID | O20100716000566 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063573301 | NPI | - | NPPES |
630003018 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |