TANNER PRIMARY CARE OF ROANOKE INC NPI 1255899092

NPI Information

TANNER PRIMARY CARE OF ROANOKE INC is a rural health clinic center in Roanoke, AL. TANNER PRIMARY CARE OF ROANOKE INC NPI is 1255899092. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

965 HIGHWAY 431
ROANOKE, AL
ZIP 36274-329
Phone: (334) 863-2141
Fax: (334) 863-8733

The provider's authorized official is Susan Fox .
The authorized official title is Senior Vp Of Operations and has the following contact phone number (770) 838-8302.

The CLIA number assigned to this NPI record is 01D0918083 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/12/2019 and was last updated on 4/28/2021.

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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