PICKENS COUNTY PRIMARY CARE P.C NPI 1063988806

NPI Information

PICKENS COUNTY PRIMARY CARE, P.C is a rural health clinic center in Gordo, AL. PICKENS COUNTY PRIMARY CARE, P.C NPI is 1063988806. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

630 4TH ST NW
GORDO, AL
ZIP 35466
Phone: (205) 375-6251
Fax: (205) 375-9064

The provider's authorized official is Julia L Boothe .
The authorized official title is Owner and has the following contact phone number (205) 792-6701.

The CLIA number assigned to this NPI record is 01D2197746 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2018 and was last updated on 2/19/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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