Organization · Type 2 NPI

Rural Health Medical Program, Inc

Federally Qualified Health Center (FQHC) · Vredenburgh, AL

NPI number 1104995208 Active

Practice location

558 County Road 56
Vredenburgh, AL 36481-0494

Call (334) 337-4787 Map

Fax (334) 337-4682

Mailing address

P O Box 2213, 228 Selma Avenue
Selma, AL 36702-2213

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Tessie Tramaine Harris, FNPFamily Nurse Practitioner Vredenburgh, AL NPI 1942465745

NPI record

NPI: 1104995208
Entity type: Organization (Type 2)
Issued: Nov 6, 2006
Last updated: Dec 21, 2010
Status: Active
Subpart: Yes of Rural Health Medical Program, Inc.

Other names

<unavail>
Vredenburgh Health Center · doing business as

Authorized official

Ms. Patricia Gibson
CEO
(334) 874-7428

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104995208

Rural Health Medical Program, Inc's National Provider Identifier is 1104995208, issued on Nov 6, 2006. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Vredenburgh, AL. The record was last updated on Dec 21, 2010.