| Med 360 Urgent Care Northport Llc | |
|
3250 Mcfarland Blvd Northport AL 35476-3135 | |
| (205) 487-4535 | |
| (205) 487-8875 |
| Full Name | Med 360 Urgent Care Northport Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3250 Mcfarland Blvd, Northport, Alabama |
| Authorized Official Name and Position | Farouk A Raquib (OWNER/ MD) |
| Authorized Official Contact | 2054874535 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Med 360 Urgent Care Northport Llc Po Box 1140 Winfield AL 35594-1140 Ph: (205) 487-4535 | Med 360 Urgent Care Northport Llc 3250 Mcfarland Blvd Northport AL 35476-3135 Ph: (205) 487-4535 |
| NPI Number | 1073238747 |
|---|---|
| Provider Enumeration Date | 10/05/2022 |
| Last Update Date | 03/07/2024 |
| Medicare PECOS PAC ID | 5193180297 |
|---|---|
| Medicare Enrollment ID | O20230425000451 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073238747 | NPI | - | NPPES |
| 512-92816 | Other | AL | BCBS |
| 322964 | Medicaid | AL | |
| 1477511194 | Other | AL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Farouk A Raquib |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477511194 PECOS PAC ID: 9638150840 Enrollment ID: I20040525000842 |
| Provider Name | Lauren S Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619674892 PECOS PAC ID: 4183088594 Enrollment ID: I20230918002457 |
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