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General NPI Number Information
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NPI Number | 1750773180
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Entity Type | Organization
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Legal Business Name | THE MEDLEY CORPORATION LLC
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Dates
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Enumeration Date | 02/23/2015
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Last Update Date | 02/23/2015
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Provider Practice Location Address
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Address Line | 7067 SUMMERDALE DRIVE
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City | MCCALLA
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State | AL
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Zip | 35111
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Country | US
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Telephone | 205-434-8246
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Fax |
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Provider Business Mailing Address
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Address Line | 7067 SUMMERDALE DRIVE
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City | MCCALLA
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State | AL
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Zip | 35111
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Country | US
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Telephone | 205-434-8246
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MR. ERIC A. MEDLEY
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Credential |
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Telephone | 205-434-8246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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