| Mission Medical, Inc | |
|
14001 Highway 43 Suite 24 Russellville AL 35653-2848 | |
| (256) 857-1223 | |
| (256) 857-1123 |
| Full Name | Mission Medical, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 14001 Highway 43, Russellville, Alabama |
| Authorized Official Name and Position | Carolee Cosby (OFFICE MANAGER) |
| Authorized Official Contact | 2568571223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mission Medical, Inc 14001 Highway 43 Suite 24 Russellville AL 35653-2848 Ph: (256) 857-1223 | Mission Medical, Inc 14001 Highway 43 Suite 24 Russellville AL 35653-2848 Ph: (256) 857-1223 |
| NPI Number | 1982136123 |
|---|---|
| Provider Enumeration Date | 03/28/2017 |
| Last Update Date | 03/28/2017 |
| Medicare PECOS PAC ID | 2567749450 |
|---|---|
| Medicare Enrollment ID | O20170502000957 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982136123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Melanie B Malone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851473102 PECOS PAC ID: 7416986997 Enrollment ID: I20050804000885 |
| Provider Name | Nina J Hester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467464784 PECOS PAC ID: 4981835725 Enrollment ID: I20140320001419 |
| Provider Name | Chenyi J Chenyi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922387299 PECOS PAC ID: 2264651561 Enrollment ID: I20140918002190 |
| Provider Name | Carolyn W Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245247428 PECOS PAC ID: 4981921103 Enrollment ID: I20150327001804 |
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