# 604 MEDICAL CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Monroeville Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235175266
- **Authorized official:** DEBBIE WATERS (OFFICE MANAGER)
- **Authorized official phone:** (251) 575-3266

## Contact information

- **Practice address:** 16 MEDICAL CENTER DRIVE, MONROEVILLE, AL 36460
- **Practice address phone:** (251) 575-3266
- **Practice address fax:** (251) 575-3262
- **Mailing address:** 16 MEDICAL CENTER DRIVE, MONROEVILLE, AL 36460
- **Mailing address phone:** (251) 575-3266
- **Mailing address fax:** (251) 575-3262

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/20/2006
- **Last updated:** 07/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 529911320 | — | AL |