| Faith Medical Clinic Llc | |
|
64 Mccurdy Ave N Rainsville AL 35986-4465 | |
| (256) 638-4411 | |
| (256) 638-9275 |
| Full Name | Faith Medical Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 64 Mccurdy Ave N, Rainsville, Alabama |
| Authorized Official Name and Position | Paula Henderson (NURSE PRACTITIONER) |
| Authorized Official Contact | 2566384411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Faith Medical Clinic Llc 64 Mccurdy Ave N Rainsville AL 35986-4465 Ph: (256) 638-4411 | Faith Medical Clinic Llc 64 Mccurdy Ave N Rainsville AL 35986-4465 Ph: (256) 638-4411 |
| NPI Number | 1487274650 |
|---|---|
| Provider Enumeration Date | 04/17/2020 |
| Last Update Date | 11/02/2020 |
| Medicare PECOS PAC ID | 8022429208 |
|---|---|
| Medicare Enrollment ID | O20201118002933 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487274650 | NPI | - | NPPES |
| 1912470824 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Paula Cole Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912470824 PECOS PAC ID: 5496097339 Enrollment ID: I20190425001109 |
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