| East Alabama Primary Care, Llc | |
|
1518 Professional Pkwy Ste A Auburn AL 36830-2857 | |
| (334) 321-0660 | |
| Not Available |
| Full Name | East Alabama Primary Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1518 Professional Pkwy Ste A, Auburn, Alabama |
| Authorized Official Name and Position | Rubindeep Ruby Powar (MD, ADMINISTRATOR) |
| Authorized Official Contact | 3343210060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Alabama Primary Care, Llc 1518 Professional Pkwy Ste A Auburn AL 36830-2857 Ph: (334) 321-0660 | East Alabama Primary Care, Llc 1518 Professional Pkwy Ste A Auburn AL 36830-2857 Ph: (334) 321-0660 |
| NPI Number | 1710168257 |
|---|---|
| Provider Enumeration Date | 11/26/2007 |
| Last Update Date | 05/04/2023 |
| Medicare PECOS PAC ID | 6901984913 |
|---|---|
| Medicare Enrollment ID | O20080416000273 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710168257 | NPI | - | NPPES |
| 000024978 | Medicaid | AL | |
| 529933007 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rao Meka |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275608853 PECOS PAC ID: 1658472485 Enrollment ID: I20080416000279 |
| Provider Name | Sarat Meka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952560765 PECOS PAC ID: 6800084245 Enrollment ID: I20101229000249 |
| Provider Name | Rubindeep R Powar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295045631 PECOS PAC ID: 4284054669 Enrollment ID: I20201111001498 |
| Provider Name | Kelly D Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598374233 PECOS PAC ID: 7113331703 Enrollment ID: I20210121002255 |
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