| Autaugaville Family Health Center | |
|
203 N Taylor St Autaugaville AL 36003-2663 | |
| (334) 365-4524 | |
| (334) 365-8603 |
| Full Name | Autaugaville Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 203 N Taylor St, Autaugaville, Alabama |
| Authorized Official Name and Position | Susie Ann Beal (CFO) |
| Authorized Official Contact | 3344205001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Autaugaville Family Health Center Po Box 70365 Montgomery AL 36107-0365 Ph: (334) 420-5038 | Autaugaville Family Health Center 203 N Taylor St Autaugaville AL 36003-2663 Ph: (334) 365-4524 |
| NPI Number | 1992727853 |
|---|---|
| Provider Enumeration Date | 07/23/2006 |
| Last Update Date | 11/29/2023 |
| Medicare PECOS PAC ID | 1557324811 |
|---|---|
| Medicare Enrollment ID | O20110622000632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992727853 | NPI | - | NPPES |
| 630006009 | Medicaid | AL | |
| 01D0996052 | Other | AL | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Rameen Hashemiyoon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346361730 PECOS PAC ID: 6002916459 Enrollment ID: I20210803001716 |
Autauga Medical Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 S Washington St Ste A, Autaugaville, AL 36003 Phone: 334-361-9979 Fax: 334-361-7858 | |
Ivy Creek Family Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 S Washington St, Autaugaville, AL 36003 Phone: 334-361-7316 Fax: 334-361-7858 |