| Donald E Beach Pc | |
|
633 Lawrence St Moulton AL 35650-1532 | |
| (256) 974-6646 | |
| (256) 974-8654 |
| Full Name | Donald E Beach Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 633 Lawrence St, Moulton, Alabama |
| Authorized Official Name and Position | Donald E Beach (OWNER) |
| Authorized Official Contact | 2569746646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Donald E Beach Pc 633 Lawrence St Moulton AL 35650-1532 Ph: (256) 974-6646 | Donald E Beach Pc 633 Lawrence St Moulton AL 35650-1532 Ph: (256) 974-6646 |
| NPI Number | 1063434108 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 08/27/2013 |
| Medicare PECOS PAC ID | 7416960869 |
|---|---|
| Medicare Enrollment ID | O20060801000292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063434108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 00009068 (Alabama) | Primary |
| Provider Name | Don E Beach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366416943 PECOS PAC ID: 9234142688 Enrollment ID: I20060807000463 |
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