Magnolia Primary Care Llc | |
4245 Balmoral Dr Sw Ste 102 Huntsville AL 35801-6456 | |
(256) 203-6676 | |
(833) 979-0980 |
Full Name | Magnolia Primary Care Llc |
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Speciality | Internal Medicine |
Location | 4245 Balmoral Dr Sw Ste 102, Huntsville, Alabama |
Authorized Official Name and Position | Rohini Ramamoorthy (PHYSICIAN) |
Authorized Official Contact | 2562036676 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Magnolia Primary Care Llc 4245 Balmoral Dr Sw Ste 102 Huntsville AL 35801-6456 Ph: (256) 203-6676 | Magnolia Primary Care Llc 4245 Balmoral Dr Sw Ste 102 Huntsville AL 35801-6456 Ph: (256) 203-6676 |
NPI Number | 1013518265 |
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Provider Enumeration Date | 11/04/2020 |
Last Update Date | 01/13/2021 |
Medicare PECOS PAC ID | 8224441084 |
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Medicare Enrollment ID | O20210115001604 |
Identifier | Type | State | Issuer |
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1013518265 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Rohini Ramamoorthy |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1265889448 PECOS PAC ID: 4981986478 Enrollment ID: I20191119001949 |
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