| Petersville Family Care | |
|
2929 Cloverdale Rd Florence AL 35633 | |
| (256) 366-3551 | |
| Not Available |
| Full Name | Petersville Family Care |
|---|---|
| Speciality | Family Medicine |
| Location | 2929 Cloverdale Rd, Florence, Alabama |
| Authorized Official Name and Position | Susan Denise Miller (OWNER) |
| Authorized Official Contact | 2562757125 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Petersville Family Care 2929 Cloverdale Rd Unit D Florence AL 35633-1505 Ph: (256) 275-7125 | Petersville Family Care 2929 Cloverdale Rd Florence AL 35633 Ph: (256) 366-3551 |
| NPI Number | 1477040483 |
|---|---|
| Provider Enumeration Date | 04/16/2018 |
| Last Update Date | 05/03/2024 |
| Medicare PECOS PAC ID | 0648522243 |
|---|---|
| Medicare Enrollment ID | O20181101000689 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477040483 | NPI | - | NPPES |
| 1265837769 | Other | AL | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 1-01128 (Alabama) | Primary |
| Provider Name | Susan Denise Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265837769 PECOS PAC ID: 2668794322 Enrollment ID: I20141208001490 |
| Provider Name | Amanda Diane Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023723053 PECOS PAC ID: 5395118582 Enrollment ID: I20230309001299 |
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