| Sweet Home Primary Care, Llc | |
|
2231 Trenton Dr Tuscaloosa AL 35406-1622 | |
| (205) 657-0711 | |
| (205) 270-7118 |
| Full Name | Sweet Home Primary Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2231 Trenton Dr, Tuscaloosa, Alabama |
| Authorized Official Name and Position | Tiffany Williams (OWNER, PROVIDER) |
| Authorized Official Contact | 2055233435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sweet Home Primary Care, Llc Po Box 1962 Tuscaloosa AL 35403-1962 Ph: (205) 657-0711 | Sweet Home Primary Care, Llc 2231 Trenton Dr Tuscaloosa AL 35406-1622 Ph: (205) 657-0711 |
| NPI Number | 1235911595 |
|---|---|
| Provider Enumeration Date | 10/19/2023 |
| Last Update Date | 10/19/2023 |
| Medicare PECOS PAC ID | 6709239155 |
|---|---|
| Medicare Enrollment ID | O20240201001438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235911595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Steven Coppock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164635926 PECOS PAC ID: 1951443225 Enrollment ID: I20100125000582 |
| Provider Name | Tiffany D Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902288848 PECOS PAC ID: 1052626595 Enrollment ID: I20150813009553 |
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