| Custom Family Care | |
|
279 Hughes Rd Madison AL 35758-1142 | |
| (256) 289-1733 | |
| Not Available |
| Full Name | Custom Family Care |
|---|---|
| Speciality | Family Medicine |
| Location | 279 Hughes Rd, Madison, Alabama |
| Authorized Official Name and Position | Ivan Pivovarov (PRESIDENT) |
| Authorized Official Contact | 2563250480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Family Care 279 Hughes Rd Madison AL 35758-1142 Ph: () - | Custom Family Care 279 Hughes Rd Madison AL 35758-1142 Ph: (256) 289-1733 |
| NPI Number | 1053839811 |
|---|---|
| Provider Enumeration Date | 08/31/2017 |
| Last Update Date | 06/02/2021 |
| Medicare PECOS PAC ID | 6002171717 |
|---|---|
| Medicare Enrollment ID | O20180530002326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053839811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Ivan A Pivovarov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467662148 PECOS PAC ID: 4385712413 Enrollment ID: I20081002000479 |
| Provider Name | Dawn Marie Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598464307 PECOS PAC ID: 4082079983 Enrollment ID: I20230428000204 |
Dr. Sunita Puri Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8075 Madison Blvd Ste 106, Madison, AL 35758 Phone: 256-464-6004 Fax: 256-464-0403 | |
Caswall C Harrigan Physician Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Madison Medical Plaza 540 Hughes Road, Suite 14, Madison, AL 35758 Phone: 256-426-0802 | |
Heritage Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12205 County Line Rd, Suite B, Madison, AL 35758 Phone: 256-990-8446 Fax: 256-461-0393 | |
Tennessee Valley Internal Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3809 Sullivan St, Suite 7, Madison, AL 35758 Phone: 256-428-1096 Fax: 256-428-1097 | |
American Family Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7559 Hwy 72 W, Madison, AL 35758 Phone: 256-562-0850 Fax: 256-562-0854 | |
Madison Family Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3776 Sullivan St, Suite D, Madison, AL 35758 Phone: 256-325-0302 Fax: 256-325-0391 |