| 360care Services Of Al Llc | |
|
150 S Perry St Montgomery AL 36104-4227 | |
| (502) 244-2441 | |
| (502) 254-4069 |
| Full Name | 360care Services Of Al Llc |
|---|---|
| Speciality | Audiologist |
| Location | 150 S Perry St, Montgomery, Alabama |
| Authorized Official Name and Position | Joy L Stevens (DIRECTOR OF REVENUE) |
| Authorized Official Contact | 5022442441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 360care Services Of Al Llc 12910 Shelbyville Rd Ste 300 Louisville KY 40243-2404 Ph: (502) 244-2441 | 360care Services Of Al Llc 150 S Perry St Montgomery AL 36104-4227 Ph: (502) 244-2441 |
| NPI Number | 1710493176 |
|---|---|
| Provider Enumeration Date | 12/21/2017 |
| Last Update Date | 10/29/2021 |
| Certification Date | 10/29/2021 |
| Medicare PECOS PAC ID | 7719240977 |
|---|---|
| Medicare Enrollment ID | O20180423000351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710493176 | NPI | - | NPPES |
| Provider Name | La'shonda A Moore |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1518993310 PECOS PAC ID: 1658285861 Enrollment ID: I20031112000811 |
| Provider Name | Samuel Riase |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003929886 PECOS PAC ID: 2860432705 Enrollment ID: I20050510000557 |
| Provider Name | Christopher J Deporter |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1669592796 PECOS PAC ID: 4284640681 Enrollment ID: I20060223000658 |
| Provider Name | Joe B Griffin |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1477731313 PECOS PAC ID: 9133206535 Enrollment ID: I20080409000666 |
| Provider Name | Keturah Craig |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1386814457 PECOS PAC ID: 7214016252 Enrollment ID: I20080502000147 |
| Provider Name | Sidney I Greenberg |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548342660 PECOS PAC ID: 5991858169 Enrollment ID: I20090805000574 |
| Provider Name | Dana S Tulloss |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1487801940 PECOS PAC ID: 7719037076 Enrollment ID: I20090818000713 |
| Provider Name | Stacy Elizabeth Heller |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427382530 PECOS PAC ID: 7416141569 Enrollment ID: I20101102001083 |
| Provider Name | Irwin H Fingerman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124043831 PECOS PAC ID: 9436114907 Enrollment ID: I20101228000017 |
| Provider Name | Lynn Carmichael |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1013165349 PECOS PAC ID: 2769661677 Enrollment ID: I20110125000359 |
| Provider Name | Brian W Roberts |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245299866 PECOS PAC ID: 2668646910 Enrollment ID: I20111122000741 |
| Provider Name | Stuart J Alter |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1750301677 PECOS PAC ID: 0749349868 Enrollment ID: I20111213000685 |
| Provider Name | Kendra Mills |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780945568 PECOS PAC ID: 2466698931 Enrollment ID: I20130429000667 |
| Provider Name | Heather Nicole Sutton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871901231 PECOS PAC ID: 1658592183 Enrollment ID: I20141024001635 |
| Provider Name | Caitlyn P Roberts |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1083065841 PECOS PAC ID: 5597058560 Enrollment ID: I20160728000907 |
| Provider Name | Kelly Jo Kovach |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1770869844 PECOS PAC ID: 4082968086 Enrollment ID: I20181109001641 |
| Provider Name | Edward Byron Eppes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831668631 PECOS PAC ID: 1759628118 Enrollment ID: I20190123004378 |
| Provider Name | James Fitzgerald Noel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1356303416 PECOS PAC ID: 8729046081 Enrollment ID: I20190402000893 |
| Provider Name | Ronald David Agee |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1982116950 PECOS PAC ID: 5496083693 Enrollment ID: I20190827000264 |
| Provider Name | Deborah Howell |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1760090229 PECOS PAC ID: 5597180257 Enrollment ID: I20200729001452 |
| Provider Name | Kelsie Morgan Graffagnino |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770108573 PECOS PAC ID: 7315352333 Enrollment ID: I20210224001259 |
| Provider Name | Leah G Barter |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1386991768 PECOS PAC ID: 9739581562 Enrollment ID: I20210715001789 |
| Provider Name | Susannah Standal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588723019 PECOS PAC ID: 5193628634 Enrollment ID: I20210927002840 |
| Provider Name | Elizabeth Marie Cote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679147409 PECOS PAC ID: 0042600637 Enrollment ID: I20211214003113 |
| Provider Name | Carmelita Leslie Harbeson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1013368257 PECOS PAC ID: 7012244726 Enrollment ID: I20220215002200 |
| Provider Name | Punitkumar Bhakta |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205399383 PECOS PAC ID: 0143608489 Enrollment ID: I20220527001672 |
| Provider Name | Heather Purman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750942181 PECOS PAC ID: 0648608612 Enrollment ID: I20221015000066 |
| Provider Name | Frederick Wiseman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1972506558 PECOS PAC ID: 4385627793 Enrollment ID: I20221031000480 |
| Provider Name | Troy Morton |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1942249057 PECOS PAC ID: 5698787182 Enrollment ID: I20230615002441 |
| Provider Name | Nicholas A Lalios |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1538693536 PECOS PAC ID: 0840569679 Enrollment ID: I20230808002400 |
| Provider Name | Francesca Rose Sikorski |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1629641584 PECOS PAC ID: 5890199483 Enrollment ID: I20231005000576 |
| Provider Name | Lynnette B Bardolf |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1326117367 PECOS PAC ID: 1658729686 Enrollment ID: I20231130002686 |
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