Healthcare Provider Details

I. General information

NPI: 1063872596
Provider Name (Legal Business Name): ECM TVCC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 VETERANS DR STE 200
FLORENCE AL
35630-4930
US

IV. Provider business mailing address

1751 VETERANS DR STE 200
FLORENCE AL
35630-4930
US

V. Phone/Fax

Practice location:
  • Phone: 256-766-2118
  • Fax:
Mailing address:
  • Phone: 256-766-2118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE LAWRENCE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000