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General NPI Number Information
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NPI Number | 1699490847
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Entity Type | Organization
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Legal Business Name | PEDIATRIC CARE OF CHELSEA, LLC
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 15582 HIGHWAY 280 STE 110
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City | CHELSEA
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State | AL
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Zip | 35043-8361
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Country | US
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Telephone | 205-800-8713
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Fax |
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Provider Business Mailing Address
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Address Line | 292 CHESSER PARK DR
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City | CHELSEA
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State | AL
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Zip | 35043-8197
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE VARNER
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Credential |
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Telephone | 205-218-8987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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