| Ivy Creek Of Butler, Llc. | |
|
125 Church Street Georgiana AL 36033 | |
| (334) 376-2291 | |
| (334) 376-3655 |
| Full Name | Ivy Creek Of Butler, Llc. |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 125 Church Street, Georgiana, Alabama |
| Authorized Official Name and Position | David Glenn Wilcox (CFO) |
| Authorized Official Contact | 3343832423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivy Creek Of Butler, Llc. 300 N College St Greenville AL 36037 Ph: (334) 382-2681 | Ivy Creek Of Butler, Llc. 125 Church Street Georgiana AL 36033 Ph: (334) 376-2291 |
| NPI Number | 1245372168 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 06/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245372168 | NPI | - | NPPES |
| 540003424 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 11769 (Alabama) | Primary |
The Health Care Authority Of The City Of Greenville - Lv Stabler Hospi Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 125 Church St, Georgiana, AL 36033 Phone: 334-376-2963 Fax: 334-376-3657 | |
Evergreen Medical Center, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 225 Patterson Ave # A, Georgiana, AL 36033 Phone: 251-578-2480 | |
Tri County Medical Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 138 Jones St, Georgiana, AL 36033 Phone: 334-376-0078 Fax: 334-376-0144 |