Full Life Regeneration, Pc is a medicare enrolled "Clinic/center - Multi-specialty" provider in Florence, Alabama. Their current practice location is
117 Renaissance St, Florence, Alabama. You can reach out to their office (for appointments etc.) via phone at
(256) 765-0002.
Full Life Regeneration, Pc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Full Life Regeneration, Pc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1609464395.
Healthcare Provider's Profile
| Full Name | Full Life Regeneration, Pc |
|---|
| Type | Facility |
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| Speciality | Clinic/center - Multi-specialty |
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| Location | 117 Renaissance St, Florence, Alabama |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1609464395
- Provider Enumeration Date: 01/07/2021
- Last Update Date: 05/26/2021
Medicare PECOS Information:
- PECOS PAC ID: 7911308184
- Enrollment ID: O20210624003230
Medical Identifiers
Medical identifiers for Full Life Regeneration, Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609464395 | NPI | - | NPPES |
| 1769 | Other | AL | LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Full Life Regeneration, Pc acts as a billing entity for following providers:
| Provider Name | Michael Andrew Marino |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1699742692
PECOS PAC ID: 1355432345
Enrollment ID: I20070806000344 |
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| Provider Name | Leeann Boyles Stanford |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1710316476
PECOS PAC ID: 0143450346
Enrollment ID: I20150504001077 |
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| Provider Name | Matthew Melson |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1114304730
PECOS PAC ID: 3476808858
Enrollment ID: I20180626003491 |
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| Provider Name | Clint Lester |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1902458136
PECOS PAC ID: 4385974427
Enrollment ID: I20191002002838 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Full Life Regeneration, Pc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Full Life Regeneration, Pc
117 Renaissance St,
Florence, AL 35630-1207
Ph: (256) 765-0002 | Full Life Regeneration, Pc
117 Renaissance St,
Florence, AL 35630-1207
Ph: (256) 765-0002 |
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