Healthcare Provider Details

I. General information

NPI: 1841384534
Provider Name (Legal Business Name): LIMESTONE COMMUNITY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25565 LEVIE DAVIS DRIVE
ELKMONT AL
35620
US

IV. Provider business mailing address

25565 LEVIE DAVIS DRIVE P.O. BOX 449
ELKMONT AL
35620
US

V. Phone/Fax

Practice location:
  • Phone: 256-732-3712
  • Fax: 256-732-3714
Mailing address:
  • Phone: 256-732-3712
  • Fax: 256-732-3714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19353
License Number StateAL

VIII. Authorized Official

Name: WAYNE AUBREY JONES
Title or Position: OWNER
Credential: M.D.
Phone: 256-732-3712