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12731 Highway 17 Gilbertown AL 36908 | |
(251) 843-2887 | |
(251) 843-2535 |
Full Name | |
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Speciality | Clinic/Center |
Location | 12731 Highway 17, Gilbertown, Alabama |
Authorized Official Name and Position | Don Larkin Kennedy (REGIONAL CEO) |
Authorized Official Contact | 6017039614 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dept 3022, P.o. Box 1000 Memphis TN 38148-3022 Ph: (601) 213-3010 | 12731 Highway 17 Gilbertown AL 36908 Ph: (251) 843-2887 |
NPI Number | 1275050189 |
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Provider Enumeration Date | 08/23/2017 |
Last Update Date | 04/26/2023 |
Medicare PECOS PAC ID | 0244498368 |
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Medicare Enrollment ID | O20180123001203 |
Identifier | Type | State | Issuer |
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1275050189 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |