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General NPI Number Information
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NPI Number | 1972985968
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Entity Type | Organization
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Legal Business Name | ATHENS LIMESTONE PEDIATRIC CENTER LLC
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 101 FITNESS WAY STE 2100
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City | ATHENS
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State | AL
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Zip | 35611-2494
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Country | US
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Telephone | 256-216-9730
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Fax | 256-216-9731
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Provider Business Mailing Address
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Address Line | 700 W MARKET ST
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City | ATHENS
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State | AL
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Zip | 35611-2457
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Country | US
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Telephone | 256-216-9730
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Fax | 256-216-9731
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Authorized Official
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Title or Position | COMPLIANCE DIRECTOR
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Name | SEBRINA HOLT
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Credential |
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Telephone | 256-216-9648
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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 |
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License Number State |
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