Pine Apple Health Center | |
867 County Road 59 Pine Apple AL 36768-3525 | |
(251) 746-2197 | |
(251) 746-2467 |
Full Name | Pine Apple Health Center |
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Speciality | Clinic/Center |
Location | 867 County Road 59, Pine Apple, Alabama |
Authorized Official Name and Position | Patricia Gibson (CEO) |
Authorized Official Contact | 3348747428 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pine Apple Health Center P O Box 2213 228 Selma Avenue Selma AL 36702-2213 Ph: (334) 874-7428 | Pine Apple Health Center 867 County Road 59 Pine Apple AL 36768-3525 Ph: (251) 746-2197 |
NPI Number | 1295804391 |
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Provider Enumeration Date | 11/06/2006 |
Last Update Date | 12/21/2010 |
Medicare PECOS PAC ID | 0143219196 |
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Medicare Enrollment ID | O20101117001649 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295804391 | NPI | - | NPPES |
011836 | Other | AL | MEDICARE ID - TYPE UNSPECIFIED |
630000008 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Alabama) | Primary |