Organization
LAVACA PRIMARY HEALTH SYSTEMS, LLC
Active
Organization
LAVACA PRIMARY HEALTH SYSTEMS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINAL N VINES (OWNER)
(470) 235-9354
Entity
Organization
Contact information
Practice address
3915 PALISADES DR STE C, TUSCALOOSA, AL 35405-3415
(205) 248-2073
Mailing address
1105 SOUTHVIEW LN # 103-140, TUSCALOOSA, AL 35405-6390
(470) 235-9354
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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