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NPI Code Detail

MEDICARE: HMC RURAL HEALTH CLINIC LLC

MEDICARE: HMC RURAL HEALTH CLINIC LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174525950
Entity Type Code : Organization
Provider Name (Legal Business Name) : HMC RURAL HEALTH CLINIC LLC
Provider Business Mailing Address
First Line : PO BOX 1571
Second Line :
City : JASPER
State : AL
Zip : 35502-1571
Country : US
Telephone Number : 205-221-9351
Fax Number : 205-221-3700
Provider Business Practice Location Address
First Line : 2201 N AIRPORT RD
Second Line :
City : JASPER
State : AL
Zip : 35504-7058
Country : US
Telephone Number : 205-221-9351
Fax Number : 205-221-3700
Authorized Official
Title or Position : ASSISTANT OFFICE MANAGER
Name : DELINDA STILES
Credential :
Telephone Number : 205-221-9351
Provider Enumeration Date : 08/11/2005
Last Update Date : 05/09/2019

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Directions to “HMC RURAL HEALTH CLINIC LLC ” Practice Location

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