| |
1083 East Relham Dr Loxley AL 36551 | |
(251) 964-4011 | |
(251) 436-7765 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1083 East Relham Dr, Loxley, Alabama |
Authorized Official Name and Position | Charles White (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2514348177 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 2048 Mobile AL 36652-2048 Ph: (251) 434-8177 | 1083 East Relham Dr Loxley AL 36551 Ph: (251) 964-4011 |
NPI Number | 1447229208 |
---|---|
Provider Enumeration Date | 03/15/2006 |
Last Update Date | 08/30/2022 |
Medicare PECOS PAC ID | 1658356308 |
---|---|
Medicare Enrollment ID | O20080521000818 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447229208 | NPI | - | NPPES |
630006014 | Medicaid | AL |