| Southern Blessings Adult And Pediatric Housecall Llc | |
|
1402 Pineview Rd Jasper AL 35504-8906 | |
| (606) 302-1233 | |
| Not Available |
| Full Name | Southern Blessings Adult And Pediatric Housecall Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1402 Pineview Rd, Jasper, Alabama |
| Authorized Official Name and Position | Tiffany Tolliver (OWNER) |
| Authorized Official Contact | 6063021233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Blessings Adult And Pediatric Housecall Llc 1402 Pineview Rd Jasper AL 35504-8906 Ph: (606) 302-1233 | Southern Blessings Adult And Pediatric Housecall Llc 1402 Pineview Rd Jasper AL 35504-8906 Ph: (606) 302-1233 |
| NPI Number | 1740877257 |
|---|---|
| Provider Enumeration Date | 12/30/2020 |
| Last Update Date | 12/30/2020 |
| Medicare PECOS PAC ID | 2264822980 |
|---|---|
| Medicare Enrollment ID | O20211210001611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740877257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Julie Grace Knop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275038549 PECOS PAC ID: 9739439845 Enrollment ID: I20180912000096 |
| Provider Name | Tiffany Tolliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003473877 PECOS PAC ID: 1254668130 Enrollment ID: I20190815001197 |
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