Organization
TOWN OF SLOCOMB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDY ANDERSON (OFFICE ASSISTANT)
(334) 589-3038
Entity
Organization
Contact information
Practice address
324 S STATE HIGHWAY 103, SLOCOMB, AL 36375-6533
(334) 886-7419
(334) 886-9896
Mailing address
PO BOX 608, SLOCOMB, AL 36375-0608
(334) 886-7419
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
874
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000079450
—
AL
01
—
51079450
BLUE CROSS
AL
Enumeration date
10/05/2006
Last updated
08/01/2024
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