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Organization

EVERGREEN MEDICAL CENTER LLC

Active
Parent organization
EVERGREEN MEDICAL CENTER LLC
Other names
Evergreen Home Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
EVERGREEN MEDICAL CENTER LLC
Authorized official
MRS. SHARON JONES (CFO)
(251) 578-2480
Entity
Organization

Contact information

Practice address
308 SOUTH MAIN ST, EVERGREEN, AL 36401
(251) 578-6800
(251) 578-0252
Mailing address
308 SOUTH MAIN ST, EVERGREEN, AL 36401
(251) 578-6800
(251) 578-0252

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
10419
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51043109
BC BS
AL
05
GIL7106A
AL
Enumeration date
11/28/2005
Last updated
01/03/2008
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