Montgomery Primary Care | |
3060 Mobile Hwy Montgomery AL 36108-4027 | |
(334) 293-6670 | |
(334) 293-6676 |
Full Name | Montgomery Primary Care |
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Speciality | Clinic/Center |
Location | 3060 Mobile Hwy, Montgomery, Alabama |
Authorized Official Name and Position | Susie Ann Beal (CFO) |
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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Montgomery Primary Care Po Box 70365 Montgomery AL 36107-0365 Ph: (334) 263-2301 | Montgomery Primary Care 3060 Mobile Hwy Montgomery AL 36108-4027 Ph: (334) 293-6670 |
NPI Number | 1528082336 |
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Provider Enumeration Date | 07/26/2006 |
Last Update Date | 11/29/2023 |
Medicare PECOS PAC ID | 1557324811 |
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Medicare Enrollment ID | O20100707000180 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528082336 | NPI | - | NPPES |
630002009 | Medicaid | AL | |
01D0967315 | Other | AL | CLIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Audrey Fields |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1023509932 PECOS PAC ID: 4183978240 Enrollment ID: I20210322000565 |
Provider Name | Rameen Hashemiyoon |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346361730 PECOS PAC ID: 6002916459 Enrollment ID: I20210803001716 |
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