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General NPI Number Information
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NPI Number | 1619623915
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Entity Type | Organization
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Legal Business Name | S.C.R.E.E.N.S. LLC
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 1400 COMMERCE BLVD STE 17
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City | ANNISTON
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State | AL
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Zip | 36207-9454
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Country | US
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Telephone | 256-225-6737
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Fax | 919-590-1895
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Provider Business Mailing Address
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Address Line | 212 E 28TH ST
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City | ANNISTON
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State | AL
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Zip | 36201-2930
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Country | US
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Telephone | 256-225-6737
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Fax | 919-590-1895
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Authorized Official
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Title or Position | OWNER
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Name | MR. EUGENE CLIFFORD THOMAS III
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Credential |
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Telephone | 256-225-6737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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