Organization
TRI COUNTY MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN J SAWYER (EXECUTIVE DIRECTOR)
(251) 578-1163
Entity
Organization
Contact information
Practice address
316 S MAIN ST, EVERGREEN, AL 36401-3325
(251) 578-1163
Mailing address
PO BOX 726, 316 SOUTH MAIN STREET, EVERGREEN, AL 36401-0726
(251) 578-1163
(251) 578-1163
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
630000017
—
AL
01
—
CD9346
RAILROAD MEDICARE GROUP
AL
01
—
DD4470
RAILROAD MEDICAID GROUP
AL
Enumeration date
10/25/2006
Last updated
04/28/2008
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