| Ourtown Family Care Llc | |
|
1025 Medical Center Pkwy Selma AL 36701 | |
| (334) 875-8833 | |
| Not Available |
| Full Name | Ourtown Family Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1025 Medical Center Pkwy, Selma, Alabama |
| Authorized Official Name and Position | Sai S Namburu (PARTNER) |
| Authorized Official Contact | 3348758833 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ourtown Family Care Llc 1025 Medical Center Pkwy Selma AL 36701-6780 Ph: (334) 875-8833 | Ourtown Family Care Llc 1025 Medical Center Pkwy Selma AL 36701 Ph: (334) 875-8833 |
| NPI Number | 1801157706 |
|---|---|
| Provider Enumeration Date | 06/06/2012 |
| Last Update Date | 08/08/2018 |
| Medicare PECOS PAC ID | 3870720824 |
|---|---|
| Medicare Enrollment ID | O20131218001243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801157706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Thang Q An |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972580744 PECOS PAC ID: 5395648125 Enrollment ID: I20040129000682 |
| Provider Name | Sai Shankar Namburu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205894003 PECOS PAC ID: 2163446121 Enrollment ID: I20060118000340 |
| Provider Name | Vijay Tirumalasetty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760618003 PECOS PAC ID: 8325295645 Enrollment ID: I20120821001042 |
| Provider Name | Deborah L Mccollum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437695681 PECOS PAC ID: 4688950165 Enrollment ID: I20170418001022 |
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