Prattville Medical Clinic, Pc | |
1739 E Main St Prattville AL 36066-5525 | |
(334) 358-8106 | |
(334) 358-8107 |
Full Name | Prattville Medical Clinic, Pc |
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Speciality | Internal Medicine |
Location | 1739 E Main St, Prattville, Alabama |
Authorized Official Name and Position | Charlton H Trinidad (OWNER) |
Authorized Official Contact | 3343588106 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Prattville Medical Clinic, Pc 2257 Taylor Rd Suite 200 Montgomery AL 36117-7790 Ph: (334) 270-9914 | Prattville Medical Clinic, Pc 1739 E Main St Prattville AL 36066-5525 Ph: (334) 358-8106 |
NPI Number | 1144318312 |
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Provider Enumeration Date | 10/11/2006 |
Last Update Date | 10/12/2007 |
Medicare PECOS PAC ID | 0840217188 |
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Medicare Enrollment ID | O20051026000981 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144318312 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Sylvania S Trinidad |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1669560835 PECOS PAC ID: 6103940911 Enrollment ID: I20101020000986 |
Provider Name | Charlton H Trinidad |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1366530529 PECOS PAC ID: 8820112634 Enrollment ID: I20101025000111 |
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