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General NPI Number Information
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NPI Number | 1528467388
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Entity Type | Organization
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Legal Business Name | MED CARE LLC
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 2605 GAULT AVE N SUITE 200
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City | FORT PAYNE
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State | AL
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Zip | 35967-3751
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Country | US
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Telephone | 256-451-1250
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Fax | 256-451-1270
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Provider Business Mailing Address
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Address Line | PO BOX 246
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City | PISGAH
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State | AL
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Zip | 35765-0246
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Country | US
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Telephone | 256-451-1250
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Fax | 256-451-1270
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Authorized Official
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Title or Position | OWNER
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Name | MUHAMMAD E ATA
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Credential | MD
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Telephone | 256-451-1250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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