Provider Demographics
NPI:1033155791
Name:ATTENTUS MOULTON, LLC
Entity Type:Organization
Organization Name:ATTENTUS MOULTON, LLC
Other - Org Name:LAWRENCE RURAL HEALTH CLINIC,COURTLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-974-2286
Mailing Address - Street 1:350 TENNESSEE STREET
Mailing Address - Street 2:
Mailing Address - City:COURTLAND
Mailing Address - State:AL
Mailing Address - Zip Code:35618
Mailing Address - Country:US
Mailing Address - Phone:256-637-8033
Mailing Address - Fax:256-637-9424
Practice Address - Street 1:350 TENNESSEE STREET
Practice Address - Street 2:
Practice Address - City:COURTLAND
Practice Address - State:AL
Practice Address - Zip Code:35618
Practice Address - Country:US
Practice Address - Phone:256-637-8033
Practice Address - Fax:256-637-9424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL540003401Medicaid
AL540003401Medicaid
ALK401Medicare PIN