| Labridgette R. Ellis Medical And Dental Center | |
|
800 Hall St Greensboro AL 36744 | |
| (334) 624-7270 | |
| (334) 624-0872 |
| Full Name | Labridgette R. Ellis Medical And Dental Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 Hall St, Greensboro, Alabama |
| Authorized Official Name and Position | David Gay (CEO) |
| Authorized Official Contact | 2057586647 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Labridgette R. Ellis Medical And Dental Center 2731 Mlk Jr Blvd Tuscaloosa AL 35401-5235 Ph: (205) 349-3250 | Labridgette R. Ellis Medical And Dental Center 800 Hall St Greensboro AL 36744 Ph: (334) 624-7270 |
| NPI Number | 1285655936 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 05/17/2022 |
| Medicare PECOS PAC ID | 8224921705 |
|---|---|
| Medicare Enrollment ID | O20101116000886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285655936 | NPI | - | NPPES |
| 630006005 | Medicaid | AL | |
| I747 | Other | AL | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Magnolia Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 850 Tuscaloosa St Ste A, Greensboro, AL 36744 Phone: 601-832-0662 | |
Hale County Hospital Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 508 Greene St, Greensboro, AL 36744 Phone: 334-624-4442 Fax: 334-624-1405 |