Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1412 Elba Hwy, Troy, Alabama |
Authorized Official Name and Position | Pamylon Bowers (CEO) |
Authorized Official Contact | 3346706726 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1414 Elba Hwy Troy AL 36079-6020 Ph: (334) 670-6726 | 1412 Elba Hwy Troy AL 36079 Ph: (334) 566-8822 |
NPI Number | 1578625125 |
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Provider Enumeration Date | 12/13/2006 |
Last Update Date | 09/12/2022 |
Medicare PECOS PAC ID | 4789625948 |
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Medicare Enrollment ID | O20050518000248 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578625125 | NPI | - | NPPES |
630005018 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Southeast Alabama Rural Health Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1414 Elba Hwy, Troy, AL 36079 Phone: 334-670-6726 Fax: 334-670-6731 | |
Troy Family Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 Country Club Rd, Troy, AL 36079 Phone: 334-807-0235 Fax: 334-807-0099 | |