Organization
GADSDEN REGIONAL PRIMARY CARE LLC
Active
Parent organization
GADSDEN REGIONAL PRIMARY CARE LLC
Other names
Ruiz Neurosurgery Clinic, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GADSDEN REGIONAL PRIMARY CARE LLC
Authorized official
DEBBIE T BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7626
Entity
Organization
Contact information
Practice address
300 MEDICAL CENTER DR, SUITE 303, GADSDEN, AL 35903-1157
(256) 494-3033
(256) 494-3036
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
(615) 465-7000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11698
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051515965
BLUE CROSS BLUE SHIELD AL
AL
Enumeration date
07/07/2006
Last updated
07/07/2008
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