MEDICARE: ACSH URGENT CARE OF ALABAMA, 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
1	261QU0200X	Urgent Care Clinic/Center
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1871868380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACSH URGENT CARE OF ALABAMA, LLC

Provider Business Mailing Address
First Line	:	PO BOX 101070
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30392-1070
Country	:	US
Telephone Number	:	404-465-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 W GRAND AVE
Second Line	:	SUITE 90
City	:	RAINBOW CITY
State	:	AL
Zip	:	35906-3275
Country	:	US
Telephone Number	:	256-459-4987
Fax Number	:	256-459-4980

Authorized Official
Title or Position	:	COO
Name	:	NORMAN WINLAND
Credential	:
Telephone Number	:	404-465-1000

Provider Enumeration Date	:	03/16/2012
Last Update Date	:	08/17/2015

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