Organization Name: | IVY CREEK OF ELMORE, LLC |
NPI Number: | 1093838880 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GORDON FAULK (CEO) |
Mailing Address: | 74186 Tallassee Hwy Wetumpka |
State: | AL US |
Postal Code: | 360925643 |
Phone Number: | 3345670346 |
Fax Number: | 3345670855 |
NPI Enumeration Date: | 04/09/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 305R00000X |
License Number: | 00011939 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Preferred Provider Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |