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2801 Willena Ave Montgomery AL 36107-1055 | |
(334) 420-5001 | |
(334) 420-0158 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2801 Willena Ave, Montgomery, Alabama |
Authorized Official Name and Position | Tracy Riedler (HUMAN RESOURCE DIRECTOR) |
Authorized Official Contact | 3344205001 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 70365 Montgomery AL 36107-0365 Ph: (334) 420-5001 | 2801 Willena Ave Montgomery AL 36107-1055 Ph: (334) 420-5001 |
NPI Number | 1427521962 |
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Provider Enumeration Date | 01/08/2019 |
Last Update Date | 04/28/2020 |
Medicare PECOS PAC ID | 1557324811 |
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Medicare Enrollment ID | O20190712000532 |
Identifier | Type | State | Issuer |
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1427521962 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Your Doctor's Office, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8630 Vaughn Rd, Montgomery, AL 36117 Phone: 334-676-4076 Fax: 334-676-4064 | |
Aikam Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2895 Zelda Rd, Montgomery, AL 36106 Phone: 334-245-5969 | |