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Organization

CENTRAL PEDIATRICS OF SOMERVILLE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTY THOMAS RUTHERFORD (CFO OFFICE MGR)
(256) 233-0712
Entity
Organization

Contact information

Practice address
3609 HIGHWAY 67 S, SOMERVILLE, AL 35670
(256) 233-0712
Mailing address
101 FITNESS WAY STE 1100, ATHENS, AL 35611-2481
(256) 233-0712

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
305R00000X
Preferred Provider Organization
Primary

Other

Enumeration date
06/28/2018
Last updated
07/11/2018
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