| Lenlock Clinic Llc | |
|
21 Bill Robinson Pkwy Anniston AL 36206-2624 | |
| (256) 463-2197 | |
| Not Available |
| Full Name | Lenlock Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 21 Bill Robinson Pkwy, Anniston, Alabama |
| Authorized Official Name and Position | Donna Blair (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2564632197 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lenlock Clinic Llc 21 Bill Robinson Pkwy Anniston AL 36206-2624 Ph: () - | Lenlock Clinic Llc 21 Bill Robinson Pkwy Anniston AL 36206-2624 Ph: (256) 463-2197 |
| NPI Number | 1750954087 |
|---|---|
| Provider Enumeration Date | 07/23/2021 |
| Last Update Date | 06/07/2022 |
| Medicare PECOS PAC ID | 2264820034 |
|---|---|
| Medicare Enrollment ID | O20211027002130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750954087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Carson W Pearce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194131136 PECOS PAC ID: 8820314487 Enrollment ID: I20150226001340 |
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