# IVY CREEK SPECIALTY CARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LMCH LOCATION
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750980819
- **Authorized official:** TERESA H LANGFORD (CREDENTIALING MANAGER)
- **Authorized official phone:** (334) 283-2542

## Contact information

- **Practice address:** 201 MARIARDEN RD, DADEVILLE, AL 36853-6244
- **Practice address phone:** (256) 825-7821
- **Mailing address:** 201 MARIARDEN RD, DADEVILLE, AL 36853-6244
- **Mailing address phone:** (256) 825-7821

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/20/2020
- **Last updated:** 10/20/2020