Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 73 Long Street, Millry, Alabama |
Authorized Official Name and Position | Jennifer L Mcnease (OWNER/PEDIATRIC NURSE PRACTITIONER) |
Authorized Official Contact | 2518463233 |
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 465 Millry AL 36558-0465 Ph: (251) 846-3233 | 73 Long Street Millry AL 36558 Ph: (251) 846-3233 |
NPI Number | 1316223027 |
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Provider Enumeration Date | 10/26/2011 |
Last Update Date | 12/20/2022 |
Medicare PECOS PAC ID | 0648444208 |
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Medicare Enrollment ID | O20111216000723 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316223027 | NPI | - | NPPES |
137591 | Medicaid | AL | |
136193 | Medicaid | AL |