| Bc Obgyn Llc | |
|
1155 Hillcrest Rd Mobile AL 36695-3921 | |
| (251) 634-1250 | |
| Not Available |
| Full Name | Bc Obgyn Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1155 Hillcrest Rd, Mobile, Alabama |
| Authorized Official Name and Position | Sharon Marie Bush-coaxum (OWNER) |
| Authorized Official Contact | 2515335608 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bc Obgyn Llc 20458 Executive Dr Tanner AL 35671-3642 Ph: (256) 444-4033 | Bc Obgyn Llc 1155 Hillcrest Rd Mobile AL 36695-3921 Ph: (251) 634-1250 |
| NPI Number | 1972266302 |
|---|---|
| Provider Enumeration Date | 10/21/2021 |
| Last Update Date | 10/21/2021 |
| Medicare PECOS PAC ID | 3779975370 |
|---|---|
| Medicare Enrollment ID | O20220111001384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972266302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Sharon M Bush-coaxum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265674196 PECOS PAC ID: 7517191125 Enrollment ID: I20131015001534 |
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