EVERGREEN MEDICAL CENTER LLC (NPI# 1427366871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427366871 |
Entity Type | Organization |
Organization Name | EVERGREEN MEDICAL CENTER LLC |
Other Organization Name | EVERGREEN PRIMARY CARE |
Practice Address |
100 Edwina Street Evergreen AL 36401-3319 |
Mailing Address |
Po Box 706 Evergreen AL 36401-0706 |
Practice Telephone | 2515780278 |
Practice Fax Number | 2515780290 |
Mailing Telephone | 2515780278 |
Mailing Fax Number | 2515780290 |
Enumeration Date | 2010-09-20 |
Last Update Date | 2012-03-27 |
Authorized Official Name | SHARON JONES (CHIEF FINANCIAL OFFICER) |
Authorized Official Telephone | 2515782480 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
EVERGREEN PRIMARY CARE | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891904223 | Evergreen Medical Center LLC | Internal Medicine | 106 Edwina St, Evergreen, AL 36401-3319 | 2007-05-22 |
1891770368 | Evergreen Medical Center LLC | General Acute Care Hospital | 101 Crestview Ave, Evergreen, AL 36401-3333 | 2005-12-07 |
1881677581 | Evergreen Medical Center LLC | Registered Nurse | 308 South Main St, Evergreen, AL 36401 | 2005-11-28 |
1356695886 | Evergreen Medical Center LLC | Emergency Medicine | 100 Edwina Street, Evergreen, AL 36401-3319 | 2012-11-06 |
Street Address |
100 EDWINA STREET |
City | EVERGREEN |
State | AL |
Zip Code | 36401-3319 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467526038 | Evergreen Dental Center | Dentist | 100 Edwina Street, Evergreen, AL 36401 | 2006-11-17 |
1356695886 | Evergreen Medical Center LLC | Emergency Medicine | 100 Edwina Street, Evergreen, AL 36401-3319 | 2012-11-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437347572 | Elizabeth L Godwin | Counselor | 101 Perryman Street Hwy 31, Compass Academy, Evergreen, AL 36401 | 2007-10-12 |
1679691661 | Floyd Michael Cartwright | Dentist | 122 Court Street, Evergreen, AL 36401 | 2007-03-27 |
1134141229 | Michael L Pitts | Physical Therapist | 124 Edwina St, Evergreen, AL 36401 | 2006-07-24 |
1275565442 | Mark A Roberts | Family Medicine | 106 Edwina Street, Evergreen, AL 36401 | 2006-07-07 |
1881677581 | Evergreen Medical Center LLC | Registered Nurse | 308 South Main St, Evergreen, AL 36401 | 2005-11-28 |
1063918118 | Jessica Roberts Pierce | Nurse Practitioner | 106 Edwina Street, Evergreen, AL 36401 | 2018-04-05 |
1962535112 | Douglas Patrick O'connor | Dentist | 104 Hillcrest Dr, Evergreen, AL 36401 | 2007-03-14 |
1952466211 | Mark A Roberts Md PC | Family Medicine | 106 Edwina Street, Evergreen, AL 36401 | 2006-12-27 |
1659540086 | State of Alabama | Public Health or Welfare | Highway 83 and I-65, Evergreen, AL 36401-0565 | 2008-02-29 |
1114447604 | Conecuh County Health Dept Std | Public Health or Welfare | 102 Wild Ave, Evergreen, AL 36401-2134 | 2017-06-26 |
Find all providers in zip 36401 |
Taxonomy Code | 261QR1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rural Health |
Definition to come... |
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1205294428 | Red Bay Hospital Outpatient Clinics LLC | Clinic/Center | 14490 County Line Road, Suite A, Muscle Shoals, AL 35661 | 2016-02-02 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.