Organization
REFORM MEDICAL CLINIC
Active
Organization
REFORM MEDICAL CLINIC
Active
Other names
Harry L Richardson
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARRY LEE RICHARDSON MD (MEDICARL DOCTOR)
(205) 375-6251
Entity
Organization
Contact information
Practice address
514 10TH AVENUE SOUTH WEST, REFORM, AL 35481-0670
(205) 375-6251
(205) 375-9064
Mailing address
514 10TH AVENUE SOUTH WEST, REFORM, AL 35481-0670
(205) 375-6251
(205) 375-9064
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
11725
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000084188
—
AL
01
—
051076801
BLUECROSS BLUE SHIELD OF ALABAMA
AL
01
—
080138169
PALMETTO GBA
AL
Enumeration date
12/15/2008
Last updated
12/15/2008
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