| River Region Health Center | |
|
1845 Cherry St Montgomery AL 36107-2613 | |
| (334) 420-5001 | |
| (334) 420-0146 |
| Full Name | River Region Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1845 Cherry St, Montgomery, Alabama |
| Authorized Official Name and Position | Tracy Riedler (HUMAN RESOURCES DIRECTOR) |
| Authorized Official Contact | 3344205001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River Region Health Center Po Box 70365 Montgomery AL 36107-0365 Ph: (334) 420-5001 | River Region Health Center 1845 Cherry St Montgomery AL 36107-2613 Ph: (334) 420-5001 |
| NPI Number | 1205844719 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 04/28/2020 |
| Medicare PECOS PAC ID | 1557324811 |
|---|---|
| Medicare Enrollment ID | O20100625000144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205844719 | NPI | - | NPPES |
| 01D0027238 | Other | AL | CLIA |
| 630000009 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Shabnam Guard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255594479 PECOS PAC ID: 7618274226 Enrollment ID: I20160328000234 |
| Provider Name | Audrey Fields |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1023509932 PECOS PAC ID: 4183978240 Enrollment ID: I20210322000565 |
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