| Russellville Hospital Family Care First Clinic | |
|
13150 Highway 43 Ste 10 Russellville AL 35653-4566 | |
| (256) 332-5901 | |
| Not Available |
| Full Name | Russellville Hospital Family Care First Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 13150 Highway 43 Ste 10, Russellville, Alabama |
| Authorized Official Name and Position | Ashoke Mukherji (CEO) |
| Authorized Official Contact | 6157320768 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Russellville Hospital Family Care First Clinic Po Box 1216 Russellville AL 35653-1216 Ph: (256) 331-2770 | Russellville Hospital Family Care First Clinic 13150 Highway 43 Ste 10 Russellville AL 35653-4566 Ph: (256) 332-5901 |
| NPI Number | 1508491093 |
|---|---|
| Provider Enumeration Date | 03/05/2020 |
| Last Update Date | 11/21/2022 |
| Medicare PECOS PAC ID | 3476878489 |
|---|---|
| Medicare Enrollment ID | O20200224000801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508491093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Philip A Haynes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083803654 PECOS PAC ID: 0446647416 Enrollment ID: I20220420002751 |
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