| Capshaw Family Care | |
|
27669 Capshaw Rd Ste A2 Harvest AL 35749-6212 | |
| (256) 216-1996 | |
| (256) 216-1940 |
| Full Name | Capshaw Family Care |
|---|---|
| Speciality | Family Medicine |
| Location | 27669 Capshaw Rd Ste A2, Harvest, Alabama |
| Authorized Official Name and Position | Sebrina B Holt (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2562169648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capshaw Family Care Po Box 999 Athens AL 35612-0999 Ph: (256) 216-1996 | Capshaw Family Care 27669 Capshaw Rd Ste A2 Harvest AL 35749-6212 Ph: (256) 216-1996 |
| NPI Number | 1104260256 |
|---|---|
| Provider Enumeration Date | 04/19/2013 |
| Last Update Date | 01/05/2024 |
| Medicare PECOS PAC ID | 2163661703 |
|---|---|
| Medicare Enrollment ID | O20130612000150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104260256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Wallace J Seay |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033274956 PECOS PAC ID: 9234108150 Enrollment ID: I20040928000769 |
| Provider Name | Bridget C Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417026964 PECOS PAC ID: 3971513565 Enrollment ID: I20060426000836 |
| Provider Name | Marilyn Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922587989 PECOS PAC ID: 2860743598 Enrollment ID: I20180919002900 |
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