| Forrest Ave Medical Clinic, Llc | |
|
1016 Forrest Ave Gadsden AL 35901-3540 | |
| (256) 549-5002 | |
| (256) 549-5003 |
| Full Name | Forrest Ave Medical Clinic, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1016 Forrest Ave, Gadsden, Alabama |
| Authorized Official Name and Position | Janie T Teschner (OWNER) |
| Authorized Official Contact | 2563933009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forrest Ave Medical Clinic, Llc 1016 Forrest Ave Gadsden AL 35901-3540 Ph: (256) 549-5002 | Forrest Ave Medical Clinic, Llc 1016 Forrest Ave Gadsden AL 35901-3540 Ph: (256) 549-5002 |
| NPI Number | 1629549068 |
|---|---|
| Provider Enumeration Date | 12/11/2018 |
| Last Update Date | 12/11/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629549068 | NPI | - | NPPES |
| 127451 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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