Organization
POARCH BAND OF CREEK INDIANS
Active
Other names
Poarch Creek Indian Health Department
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA SMITH (BUSINESS OFFICE DIRECTOR)
(251) 368-9136
Entity
Organization
Contact information
Practice address
429 BUFORD L ROLIN DR, ATMORE, AL 36502-5186
(251) 368-9136
Mailing address
5811 JACK SPRINGS RD, ATMORE, AL 36502-5025
(251) 368-9136
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0130574
NCPDP
—
05
—
630000019
—
AL
Enumeration date
08/30/2006
Last updated
05/23/2017
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