| Evergreen Medical Center, Llc | |
|
225 Patterson Ave # A Georgiana AL 36033-6628 | |
| (251) 578-2480 | |
| Not Available |
| Full Name | Evergreen Medical Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 225 Patterson Ave # A, Georgiana, Alabama |
| Authorized Official Name and Position | Melissa Diane Dunn (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 2515782480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Medical Center, Llc Po Box 706 Evergreen AL 36401-0706 Ph: (251) 578-2480 | Evergreen Medical Center, Llc 225 Patterson Ave # A Georgiana AL 36033-6628 Ph: (251) 578-2480 |
| NPI Number | 1619559812 |
|---|---|
| Provider Enumeration Date | 04/27/2021 |
| Last Update Date | 04/27/2021 |
| Medicare PECOS PAC ID | 6305942145 |
|---|---|
| Medicare Enrollment ID | O20210621002672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619559812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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