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NPI Code Detail

MEDICARE: NORTH RIVER SURGICAL CENTER, LLC

MEDICARE: NORTH RIVER SURGICAL CENTER, 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
1261QA1903XAmbulatory Surgical Clinic/Center10452AL
2261QA1903XAmbulatory Surgical Clinic/CenterU6303AL

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 : 1215926993
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH RIVER SURGICAL CENTER, LLC
Provider Business Mailing Address
First Line : 301 RICE MINE RD NE
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35406-2403
Country : US
Telephone Number : 205-750-0022
Fax Number : 205-750-2373
Provider Business Practice Location Address
First Line : 301 RICE MINE RD NE
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35406-2403
Country : US
Telephone Number : 205-750-0022
Fax Number : 205-750-2373
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : CLARENCE D HOWE
Credential : M.D.
Telephone Number : 205-750-0022
Provider Enumeration Date : 10/17/2005
Last Update Date : 04/18/2013

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Directions to “NORTH RIVER SURGICAL CENTER, LLC ” Practice Location

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