Organization
PEDIATRIC RURAL HEALTH CLINICS, INC
Active
Other names
GREENVILLE PEDIATRICS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNE KEEN CRNP (VP OF OPERATIONS)
(334) 382-9760
Entity
Organization
Contact information
Practice address
46 L V STABLER DR, GREENVILLE, AL 36037-3804
(334) 382-9760
(334) 383-9331
Mailing address
46 L V STABLER DR, GREENVILLE, AL 36037-3804
(334) 382-9760
(334) 383-9331
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
00006213
AL
208000000X
Pediatrics Physician
00006634
AL
208000000X
Pediatrics Physician
00024891
AL
363LP0200X
Pediatric Nurse Practitioner
01-069655
AL
363LP0200X
Pediatric Nurse Practitioner
Primary
1-065300
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529800610
—
AL
05
—
541003905
—
AL
Enumeration date
06/01/2006
Last updated
10/11/2012
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