Vredenburgh Health Center | |
558 County Road 56 Vredenburgh AL 36481-0494 | |
(334) 337-4787 | |
(334) 337-4682 |
Full Name | Vredenburgh Health Center |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 558 County Road 56, Vredenburgh, Alabama |
Authorized Official Name and Position | Patricia Gibson (CEO) |
Authorized Official Contact | 3348747428 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Vredenburgh Health Center P O Box 2213 228 Selma Avenue Selma AL 36702-2213 Ph: (334) 874-7428 | Vredenburgh Health Center 558 County Road 56 Vredenburgh AL 36481-0494 Ph: (334) 337-4787 |
NPI Number | 1104995208 |
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Provider Enumeration Date | 11/06/2006 |
Last Update Date | 12/21/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104995208 | NPI | - | NPPES |
011890 | Other | AL | MEDICARE ID - TYPE UNSPECIFIED |
630000008 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Alabama) | Primary |