| Rural Health Medical Program, Inc | |
|
558 County Road 56 Vredenburgh AL 36481-0494 | |
| (334) 337-4787 | |
| (334) 337-4682 |
| Full Name | Rural Health Medical Program, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 558 County Road 56, Vredenburgh, Alabama |
| Authorized Official Name and Position | Patricia Gibson (CEO) |
| Authorized Official Contact | 3348747428 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rural Health Medical Program, Inc P O Box 2213 228 Selma Avenue Selma AL 36702-2213 Ph: (334) 874-7428 | Rural Health Medical Program, Inc 558 County Road 56 Vredenburgh AL 36481-0494 Ph: (334) 337-4787 |
| NPI Number | 1104995208 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 12/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104995208 | NPI | - | NPPES |
| 011890 | Other | AL | MEDICARE ID - TYPE UNSPECIFIED |
| 630000008 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Alabama) | Primary |