| Magnolia Primary Care Llc | |
|
4245 Balmoral Dr Sw Ste 102 Huntsville AL 35801-6456 | |
| (256) 203-6676 | |
| (833) 979-0980 |
| Full Name | Magnolia Primary Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4245 Balmoral Dr Sw Ste 102, Huntsville, Alabama |
| Authorized Official Name and Position | Rohini Ramamoorthy (PHYSICIAN) |
| Authorized Official Contact | 2562036676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Primary Care Llc 4245 Balmoral Dr Sw Ste 102 Huntsville AL 35801-6456 Ph: (256) 203-6676 | Magnolia Primary Care Llc 4245 Balmoral Dr Sw Ste 102 Huntsville AL 35801-6456 Ph: (256) 203-6676 |
| NPI Number | 1013518265 |
|---|---|
| Provider Enumeration Date | 11/04/2020 |
| Last Update Date | 01/13/2021 |
| Medicare PECOS PAC ID | 8224441084 |
|---|---|
| Medicare Enrollment ID | O20210115001604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013518265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rohini Ramamoorthy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265889448 PECOS PAC ID: 4981986478 Enrollment ID: I20191119001949 |
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