Organization
WINSTON COUNTY MEDICAL CLINIC 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNARD SIMIERITSCH (OWNER)
(205) 489-3322
Entity
Organization
Contact information
Practice address
15341 HIGHWAY 278, DOUBLE SPRINGS, AL 35553-2407
(205) 489-3322
(205) 789-3325
Mailing address
15341 HIGHWAY 278, DOUBLE SPRINGS, AL 35553-2407
(205) 489-3322
(205) 789-3325
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
18982
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000036224
—
AL
05
—
051550393
—
AL
01
—
51036224
BLUE CROSS
AL
01
—
51530751
BLUE CROSS
AL
05
—
529601630
—
AL
05
—
541392401
—
AL
Enumeration date
05/29/2007
Last updated
05/21/2008
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