Organization Name: | CROMEANS CLINIC, LLC |
NPI Number: | 1194734442 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOE G. CROMEANS (OWNER) |
Mailing Address: | 507 Harley St Scottsboro |
State: | AL US |
Postal Code: | 357684218 |
Phone Number: | 2562591314 |
Fax Number: | 2562596703 |
NPI Enumeration Date: | 08/05/2006 |
NPI Last Update Date: | 08/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |