Healthcare Provider Details

I. General information

NPI: 1659826253
Provider Name (Legal Business Name): HANCEVILLE ACUTE CARE AND WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 08/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 MAIN ST SW SUITE A
HANCEVILLE AL
35077-5476
US

IV. Provider business mailing address

307 MAIN ST SW SUITE A
HANCEVILLE AL
35077-5476
US

V. Phone/Fax

Practice location:
  • Phone: 256-352-8884
  • Fax: 256-352-8887
Mailing address:
  • Phone: 256-352-8884
  • Fax: 256-352-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberMD.32514
License Number StateAL

VIII. Authorized Official

Name: KAREN BROCK CAMP
Title or Position: OFFICE MANAGER
Credential: LPN
Phone: 256-352-8884