institution
Ivy Creek Of Elmore, Llc
Rural Health Clinic/Center in Deatsville, Alabama
NPI 1578060349

Ivy Creek Of Elmore, Llc is a Rural Health Clinic/Center based in Wetumpka, AL and is specialized in Rural Health. Ivy Creek Of Elmore, Llc practices in Deatsville, AL. The NPI Number for Ivy Creek Of Elmore, Llc is 1578060349 and holds a License No. (Alabama).

The current practice location address for Ivy Creek Of Elmore, Llc is 4412 Hogan Rd, Deatsville, AL and can be reached out via phone at 334-514-4851 and via fax at 334-543-4854.

Location: 4412 Hogan Rd, Deatsville, AL, 36092-0003
institution
Provider Profile Details
NPI Number
1578060349
Provider Name
Ivy Creek Of Elmore, Llc
Credential
Provider Entity Type
Organization
Address
4412 Hogan Rd, Deatsville, AL, 36092-0003
Phone Number
334-514-4851
Fax Number
334-543-4854
Provider Enumeration Date
04/09/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01D2153925 01 AL CLIA
1608 01 AL MEDICARE B
231138 05 AL
13474 01 AL MEDICARE A
institution
Provider Business Practice Location Address Details
Address
4412 Hogan Rd
City
State
Zip
36022-3400
Phone Number
334-514-4851
Fax Number
334-543-4854
person
Provider Business Mailing Address Details
Address
4412 Hogan Rd
City
State
Zip
36022-3400
Phone Number
334-514-4851
Fax Number
334-543-4854
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rural Health
Taxonomy
License No.
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Definition
Definition to come...
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