Healthcare Provider Details

I. General information

NPI: 1386564235
Provider Name (Legal Business Name): PRICARE ADVANTAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 ALIANT PKWY
ALEXANDER CITY AL
35010-3466
US

IV. Provider business mailing address

44 ALIANT PKWY
ALEXANDER CITY AL
35010-3466
US

V. Phone/Fax

Practice location:
  • Phone: 256-234-4131
  • Fax: 256-434-5210
Mailing address:
  • Phone: 256-234-4131
  • Fax: 256-434-5210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BLAIR T GILLILAND
Title or Position: PROVIDER/OWNER
Credential: NP
Phone: 256-234-4131