Organization
ELLINGTON MEMORIAL CLINIC, LLP
Active
Other names
ELLINGTON RURAL HEALTH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANITA G CARNEY (OFFICE MGR)
(903) 796-2868
Entity
Organization
Contact information
Practice address
1011 SOUTH WILLIAMS STREET, ATLANTA, TX 75551-3245
(903) 796-2868
(903) 796-0826
Mailing address
1011 SOUTH WILLIAMS STREET, ATLANTA, TX 75551-3245
(903) 796-2868
(903) 796-0826
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
TX
261QR1300X
Rural Health Clinic/Center
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04709
BCBS
TX
05
—
133389002
—
TX
05
—
133389004
—
TX
05
—
133389005
—
TX
01
—
88966
BCBS
TX
Enumeration date
08/02/2005
Last updated
07/21/2022
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