Healthcare Provider Details

I. General information

NPI: 1538190624
Provider Name (Legal Business Name): ATTENTUS EUFAULA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 RAILROAD ST
LOUISVILLE AL
36048-3134
US

IV. Provider business mailing address

31 RAILROAD ST
LOUISVILLE AL
36048-3134
US

V. Phone/Fax

Practice location:
  • Phone: 334-688-7000
  • Fax: 334-688-7127
Mailing address:
  • Phone: 334-688-7000
  • Fax: 334-688-7127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberNOT REQUIRED IN AL
License Number State

VIII. Authorized Official

Name: RICHARD D GORE
Title or Position: PRESIDENT & CHIEF MANAGER
Credential:
Phone: 615-371-7000