| Eastside Ventures, Inc. | |
|
6945 County Highway 1 Cleveland AL 35049 | |
| (205) 625-3667 | |
| Not Available |
| Full Name | Eastside Ventures, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 6945 County Highway 1, Cleveland, Alabama |
| Authorized Official Name and Position | Vicki H Parks (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Contact | 2058383718 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastside Ventures, Inc. Po Box 232 Oneonta AL 35121-0004 Ph: (205) 625-3667 | Eastside Ventures, Inc. 6945 County Highway 1 Cleveland AL 35049 Ph: (205) 625-3667 |
| NPI Number | 1609900406 |
|---|---|
| Provider Enumeration Date | 03/15/2007 |
| Last Update Date | 02/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609900406 | NPI | - | NPPES |
| E892 | Other | MEDICARE PT B | |
| 529703160 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
St. Vincent's Blount Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6945 Country Highway 1, Cleveland, AL 35049 Phone: 205-625-3367 |