Organization
GREATER ALABAMA FAMILY FOOT CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONA RENELL GREEN DPM (CEO)
(334) 863-2530
Entity
Organization
Contact information
Practice address
469 PRICE ST, ROANOKE, AL 36274-2104
(334) 863-2530
(334) 642-3669
Mailing address
PO BOX 1026, LANETT, AL 36863-1026
(334) 863-2530
(334) 642-3669
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
193
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193
AL STATE LIC. NUMBER
AL
01
—
51510661
AL BCBS NUMBER
AL
01
—
5407030001
AL DEMERC NUMBER
AL
Enumeration date
05/16/2007
Last updated
04/20/2008
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