PREMISE HEALTH OF ALABAMA MEDICAL P.C. NPI 1508470899

NPI Information

PREMISE HEALTH OF ALABAMA MEDICAL, P.C. is a multi-specialty clinic center in Andalusia, AL. PREMISE HEALTH OF ALABAMA MEDICAL, P.C. NPI is 1508470899. The provider is registered as an organization entity type.
The provider Is Doing Business As Shaw Family Health Center Andalusia.

The provider's business location address is:

200 WAITS DR
ANDALUSIA, AL
ZIP 36421-431
Phone: (334) 427-6699
Fax: (334) 427-6683

The provider's authorized official is Jonathan Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 01D0697315 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/3/2020 and was last updated on 8/15/2022.

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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