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Organization
CENTRAL PEDIATRICS OF SOMERVILLE LLC
Active
Organization
CENTRAL PEDIATRICS OF SOMERVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY THOMAS RUTHERFORD (CFO OFFICE MGR)
(256) 233-0712
Entity
Organization
Contact information
Practice address
3609 HIGHWAY 67 S, SOMERVILLE, AL 35670
(256) 233-0712
Mailing address
101 FITNESS WAY STE 1100, ATHENS, AL 35611-2481
(256) 233-0712
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
—
—
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
06/28/2018
Last updated
07/11/2018
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