| Mendiola Pc | |
|
1003 Fairway Rd Nw Fort Payne AL 35967-8226 | |
| (256) 996-3239 | |
| Not Available |
| Full Name | Mendiola Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1003 Fairway Rd Nw, Fort Payne, Alabama |
| Authorized Official Name and Position | Carmelo C Mendiola (OWNER) |
| Authorized Official Contact | 2569972820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mendiola Pc 2202 Jordan Rd Sw Suite 101 Fort Payne AL 35968 Ph: (256) 997-2820 | Mendiola Pc 1003 Fairway Rd Nw Fort Payne AL 35967-8226 Ph: (256) 996-3239 |
| NPI Number | 1265681167 |
|---|---|
| Provider Enumeration Date | 09/16/2008 |
| Last Update Date | 09/16/2008 |
| Medicare PECOS PAC ID | 0446318430 |
|---|---|
| Medicare Enrollment ID | O20081020000510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265681167 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 17265 (Alabama) | Primary |
| Provider Name | Carmelo C Mendiola |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023063922 PECOS PAC ID: 2961405618 Enrollment ID: I20060817000608 |
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