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General NPI Number Information
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NPI Number | 1588865570
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Entity Type | Organization
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Legal Business Name | WINSTON COUNTY MEDICAL CLINIC 2
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 15341 HIGHWAY 278
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City | DOUBLE SPRINGS
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State | AL
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Zip | 35553-2407
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Country | US
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Telephone | 205-489-3322
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Fax | 205-789-3325
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Provider Business Mailing Address
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Address Line | 15341 HIGHWAY 278
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City | DOUBLE SPRINGS
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State | AL
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Zip | 35553-2407
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Country | US
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Telephone | 205-489-3322
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Fax | 205-789-3325
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Authorized Official
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Title or Position | OWNER
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Name | BERNARD SIMIERITSCH
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Credential |
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Telephone | 205-489-3322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 18982
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License Number State | AL
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