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Organization

MAIN STREET MEDICAL CLINIC LLC

Active
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Organization

MAIN STREET MEDICAL CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY SUE SUGGS CRNP (OWNER)
(205) 814-1598
Entity
Organization

Contact information

Practice address
1508 COGSWELL AVE, PELL CITY, AL 35125-1243
(205) 814-1598
(205) 814-1587
Mailing address
1508 COGSWELL AVE, PELL CITY, AL 35125-1243
(205) 814-1598
(205) 814-1587

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
113466
AL

Other

Enumeration date
03/18/2011
Last updated
03/18/2011
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