MEDICARE: USA HEALTH COMMUNITY PROVIDERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1366260325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	USA HEALTH COMMUNITY PROVIDERS LLC

Provider Business Mailing Address
First Line	:	PO BOX 36258
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-1204
Country	:	US
Telephone Number	:	251-316-2678
Fax Number	:

Provider Business Practice Location Address
First Line	:	3290 DAUPHIN ST
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36606-4014
Country	:	US
Telephone Number	:	251-344-5900
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	BENNY JOSEPH STOVER
Credential	:
Telephone Number	:	251-445-9164

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	09/30/2024

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Directions to “USA HEALTH COMMUNITY PROVIDERS LLC ” Practice Location

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