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21342 Al Highway 9 Goodwater AL 35072 | |
(256) 743-1300 | |
(256) 743-1301 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 21342 Al Highway 9, Goodwater, Alabama |
Authorized Official Name and Position | Lother E Peace (PRESIDENT/CEO) |
Authorized Official Contact | 2563297188 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 939 Alexander City AL 35011-0939 Ph: (256) 329-1709 | 21342 Al Highway 9 Goodwater AL 35072 Ph: (256) 743-1300 |
NPI Number | 1174990626 |
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Provider Enumeration Date | 08/31/2015 |
Last Update Date | 08/14/2018 |
Identifier | Type | State | Issuer |
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1174990626 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |