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Organization

SOUTHCARE CLINIC, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAMUEL J. RIBIS M.D. (OWNER)
(256) 880-5818
Entity
Organization

Contact information

Practice address
11220 MEMORIAL PKWY SW, SUITE AB, HUNTSVILLE, AL 35803-4415
(256) 880-5818
(256) 883-5346
Mailing address
11220 MEMORIAL PKWY SW, SUITE AB, HUNTSVILLE, AL 35803-4415
(256) 880-5818
(256) 883-5346

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18641
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
98764
BCBS
AL
Enumeration date
10/06/2006
Last updated
01/27/2009
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